DUKE 

UNIVERSITY 


LIBRARY 


Digitized  by  the  Internet  Archive 
in  2016  with  funding  from 
Duke  University  Libraries 


https://archive.org/details/addressdelivered01john_0 


AN  ADDRESS 

H I 

DELIVERED  BEFORE  THH 

MEDICAL  SOCIETY 


O F 


ffarlji  kaolins, 


§ecoif)3  ftqqqqi  ^eefiqg. 


m RALEIGH,  MAT  1851. 


BY  CHARLES  E.  JOHNSON,  M.  D. 


Cum  nil  sine  online  et  lege  fiat , ita  vita:  nostra  integritas  naturali  lege  constat,  et 
nobis  lumc  investigate  legem  ; sedpriusquam,  ad  nos  speutat  cognoscere  ignorantiam. 


j t 3 V y 

RALEIGH: 

PRINTED  AT  THE  OFFICE  OF  THE  “ SOUTHERN  WEEKLY  POST." 


1854. 


SUl*  f\ 


TO 

WILLIAM  C.  WARPiEU,  M,  D., 

Or  BDEKTOK,  N’OBTH  CAROLINA. 

My  Dear  Sir : 

I venture  to  inscribe  these  pages  to  you,  not  from  their  worth,  for  1 
have  not  the  vanity  to  believe  they  deserve  it  on  that  account,  but  as  a testi- 
monial of  respect  for  the  talents  and  industry  which  have  raised  you  to  the 
front  rank  of  your  profession  in  our  State;  of  esteem  for  the  social  virtues 
which  have  made  you  a bright  ornament  of  society  ; and  of  acknowledgment 
for  repeated  instances  of  disinterested  friendship  and  unsolicited  favors. 

Therefore,  with  every  kindest  wish  to  you  and  yours,  believe  me,  niy 
dear  Dr.  Warren,  your  obliged  faithful  friend. 

CHARLES  E.  JOHNSON. 

Raleigh,  North  Carolina, 

December,  1854. 


PREFACE. 


TriE  following  pages,  with  a very  few  additions, 
comprise  two  addresses  delivered  before  the  Medical 
Society  of  the  State  of  North  Carolina,  at  its  Second 
and  Fifth  Annual  Meetings.  The  first  was  prepared 
and  delivered  in  obedience  to  a call  fro  i the  Society 
to  be  its  orator  on  that  occasion.  This  circumstance 
constitutes  the  reason,  as  well  as  my  apology  for  the 
natu  e and  character  of  the  first  part  of  this  address. 

The  main  object  of  the  address,  however,  may 
not.  be,  in  the  estimation  of  others,  as  important  as 
I have  represented  it.  But  to  m)  mind,  the  fash- 
ionable method  of  treating  this  question  precludes 
philosophical  inquiry  upon  the  subject,  perpetuates 
error,  am  I verifies  the  following  observation  of  a very 
judicious  writer.  “The subject  of  the  causation  of  fe- 
ver,” says  Dr.  Merrill,  “ independent  of  decaying  in- 
fluences, has  of  late  years  gained  such  importance, 
however,  that  few  treatises  are  now  written  upon  this 
disease,  without  adverting  to  it,  although  most  of  what 
we  find  in  our  new  books,  upon  the  subject  of  fever,  is 
taken  from  the  old  ones.”  Yet,  to  determine  by  a well- 
grounded  study  of  nature,  ivhat  is  the  cause  of  perio- 
dic fevers,  what  circumstances  produce  this  cause,  and 
what  are  the  primary  laws  which  it  obeys,  are  impor- 
tant questions,  which,  rightly  considered,  in  my  judg- 
ment, do  not  belong  to  an  impracticable  transcendent- 
alism, although  they  do  belong,  unquestionably,  to 
one  of  the  most  difficult,  and  hitherto  unsuccessfully  cul- 
tivated portions  ot  our  science.  It  is  true  they  may  not 
be  determined  in  this  age  ; but  there  is  reason  to  hope 
that,  guided  by  an  advanced  physical  science,  our 


IV 


PREFACE. 


descendants  may  explore  the  gloomy  recesses  of  this 
labyrinth,  and  illumine  what  to  us  is  now  apparently 
so  obscure.  Problems  as  inaccessible  to  the  ancients 
as  these  seem  to*be  to*  us,  have  been  rendered  quite 
easy  of  solution,  by  a long  and  successful  observation 
of  facts  and  inductive  reasoning.  But  that  our  suc- 
cessors may  enter  uponheir  work  under  the  most  fa- 
vorable circumstances,  it  behooves  us  to  refute  error, 
though  sanctioned  by  time  and  the  authority  of 
great  names,  and  by  careful  observations  to  extend 
our  insight  into  the  real  and  truthful  connection  of 
natural  phenomena,  so  that  our  fixed  facts  and  actual 
instances  may  serve  them  as  so  many  starting  points, 
when  they  come  to  assume  the  completion  of  our  un- 
finished labors. 

The  second  address,  delivered  at  the  Fifth  An- 
nual Meeting  of  the  Society,  was  in  reply  to  a review 
of  the  first,  by  I)r.  Satchwell,  who  had  chosen,  of  his 
oion  accord , the  presence  of  the  Society,  as  a proper 
theatre  for  the  discussion  of  this  question.  Thus  a 
controversy  arose,  which  surely  ought  never  to  have 
been  carried  into  the  Society,  at  least,  with  an}'  dis- 
play of  feeling.  However,  as  it  was  not  of  my  seek- 
ing, and  as  I have,  I hope,  full)/  and  fairly  disposed 
of  the  subject,  I shall  take  leave  of  it  with  the  best 
feeling  in  the  world. 

Dec.  15th,  1854. 


ADDRESS. 


Mr.  President  and  Gentlemen 

of  the  Medical  Society  of  the  State : 

It  is  with  no  ordinary  feelings  of  embarrass- 
ment, and  with  a profound  distrust  of  my  ability  to 
contribute  anything  of  importance  to  your  delibera- 
tions, that  I appear  before  you  on  this  interesting 
occasion,  in  the  novel  character  of  a Public  Speaker. 
Although  I consider  myself  one  of  the  very  hum- 
blest of  the  gallant  few,  who  have  stepped  forward 
in  the  good  work  of  Medical  Reform  in  North  Caro- 
lina, “ to  perform  the  tasks  of  hope  in  the  midst  of 
despair,”  yet  I have  not  felt  at  liberty,  from  any 
considerations,  however  gratifying  to  me  personally, 
to  shrink  from  the  discharge  of  the  responsible  duty 
which  your  partiality  has  assigned  me. 

Here  I might  be  permitted  to  say  many  very 
civil,  pleasant  and  truthful  things  of  the  Medica] 
Profession ; nor  would  it  be  what  the  Lawyers  call  a 
“ departure,”  since  it  is  as  clearly  within  the  object 
of  our  Society  to  say  a kind  word  of  our  profession- 
al brethren,  as  it  is  to  inveigh  against  follies,  vulgari- 
ties and  vices,  qualities  which  the  pretenders  in  me- 
dicine have  in  common  with  some  men  of  other 
pursuits.  Whilst,  therefore,  I am  compelled  to  ad- 


8 


ADDRESS  ON  MALARIA. 


mit  that  there  are  some  practitioners  of  Medicine, 
who  are  pursuing,  in  a most  unworthy  manner,  our 
highly  honorable  and  truly  useful  profession,  I wish 
to  be  distinctly  understood  to  assert,  that  neither  the 
causes  which  originate  or  aggravate  their  vices  are 
necessarily  incident  to  the  profession  itself.  That 
such  an  objectionable  state  of  things  should  exist,  is, 
perhaps,  mainly  our  own  fault,  although  partly  ow- 
ing, I believe,  to  the  lack  of  a general  diffusion  of 
useful  knowledge,  and  to  the  existence  on  our  statute 
book  of  a very  pernicious  law.  By  reference  to  our 
Revised.  Statutes,  it  will  be  found  that  all  sorts  and 
degrees  of  Doctors,  from  the  Root  and  Cancer  and 
Thompsonian  Doctors , up  to  the  regularly  educated 
and  highly  polished  gentleman  and  physician,  stand 
upon  the  same  footing,  and  enjoy,  under  the  law,  the 
same  privileges  and  immunities  as  to  the  Doctorate. 

It  is  astonishing  how  soon  one  of  these  pretend- 
ers will  learn  to  cheat  the  public.  He  takes  all  ad- 
vantages and  seems  to  have  no  idea  of  any  other  prin- 
ciple. Cunningly  mysterious  and  secret  as  to  the 
sources  of  his  knowledge  and  the  means  which  he  em- 
ploys in  the  treatment  of  disease,  he  soon  becomes  a 
trading  sycophant  and  flatterer,  pandering  to  the 
pride  and  pleasures  of  the  few,  and  ministering  to 
the  prejudices  and  ignorance  of  the  many,  whilst  his 
own  mind  is  impenetrable  to  a single  ray  of  liberal 
knowledge, — is 

“Not  pierceable  by  power  of  any  star.” 


ADDRESS  ON  MALARIA. 


9 


However,  I shall  not  discuss  here  the  legal  pri- 
vileges, nor  the  cherished  errors  of  these  charlatans, 
who  are  so  well  versed  in  the  “ gospel  of  enlighten- 
ed selfishness11  as  to  deny  the  importance  of  every 
consideration,  the  value  of  which  they  cannot  esti- 
mate in  dollars  and  cents.  Nothing  is  to  be  made 
bv  an  arsTiment  with  or  about  them.  That  sort  of 

J O 

gratuitous  advertisement  would  only  enable  them  the 
more  readily  to  climb  up  into  public  view,  confident, 
in  their  own  minds,  that  the  application  of  the  old 
adage,  u who  shall  decide  when  Doctors  disagree,11 
could  not  result  to  their  disadvantage.  It  will  not 
be  expected  of  me,  therefore,  to  occupy  your  time 
with  any  further  allusion  to  them  particularly,  as  I 
desire  to  make  a few  remarks,  before  I pass  on  to 
the  consideration  of  the  proper  subject  of  this  essay, 
in  defence  of  the  profession  of  medicine,  the  peculiar 
advantages  we  possess  for  prosecuting  the  study  of  it 
successfully,  and  in  praise  of  those  noble  spirits  who 
bring  to  the  practice  of  their  art  learning,  humanity, 
discretion  and  integrity,  the  four  cardinal  virtues  of 
a really  deserving  physician. 

It  is  as  true  now,  as  ever,  that  the  services  of  a 
learned  and  skilful  physician  are  of  such  vital  impor- 
tance to  mankind,  that  if  medical  men  will  take  care 
to  be  distinguished,  as  a body,  for  their  humanity  and 
integrity,  their  knowledge  and  acquirements,  and 
their  high  toned  gentlemanly  bearing  and  kind  offi- 
ces toward  each  other,  they  will  soon  ensure  the  per- 


10 


ADDRESS  ON  MALARIA. 


feet  confidence  and  entire  respect  of  their  fellow 
men  ; whilst  the  blunders,  ignorance  and  misconduct 
of  unqualified  pretenders  would  attach  to  each  unde- 
serving one  of  them,  agreeably  to  his  worthlessness, 
rather  than  to  the  profession  itself.  Then,  there 
would  be  more  hope  of  a moral  regeneration  of  the 
profession  than  croakers  will  allow  is  possible,  be- 
cause the  sordid  and  selfish  even  would  begin  to  dis- 
cover that  a thorough  devotion  to  professional  sci- 
ence and  duty  is  the  surest,  if  not  the  shortest,  way 
to  wealth  and  importance  ; and  wisdom  once  acquir- 
ed, no  matter  what  the  motives  were  which  prompt- 
ed the  acquisition,  will  be  faithfully  cherished  after- 
wards, not  Only  for  the  advantages  which  it  can  con- 
fer, but  for  its  loveliness  and  virtue.  The  wise  man , 
in  describing  the  advantages  of  the  love  of  wisdom 
and  virtue,  says:  “Length  of  days  is  in  her  right, 

hand,  and  in  her  left  hand  riches  and  honor.’'  But, 
in  my  humble  judgment,  the  members  of  the  profes- 
sion, who  undertake  the  study  and  practice  of  medi- 
cine, with  a full  knowledge  of  its  relations  with  the 
various  wants,  pursuits  and  purposes  of  life,  and  with 
a determination  to  be  prepared  to  meet  these  exigen- 
cies, are  more  deserving  of  praise  for  merit  of  every 
kind  than  the  world  is  in  the  habit  of  according  to 
them. 

"A  phj'sician  skilled  our  wounds  to  heal, 

Is  more  than  armies  to  the  public  weal,” 

is  the  testimony  of  him,  who,  nearly  a thousand 


ADDEESS  ON  MALAEIA. 


11 


years  before  the  beginning  of  our  era,  sang  of  Troy 
and  her  fall ; and  shall  it  be  said  in  this  so  justly 
called  age  of  progress,  when  invention  is  every  day 
discovering  new  and  unappropriated  objects  of  inter- 
est, and  opening,  by  experiment  and  the  inductive 
method  of  reasoning,  new  fields  of  inquiry,  in  which 
every  man  may  take  an  even  start,  that  the  humble, 
but  earnest  and  truthful  disciple  of  ^Esculapitts  is  a 
less  useful,  important,  and  respectable  member  of  so- 
ciety than  he  was  in  those  ruder  tunes  ? No ; it  cannot 
be.  I will  not  believe  it.  The  love  of  useful  know- 
ledge not  only  still  exists,  but  even  burns  with  a 
more  ardent  glow  than  at  any  former  period  of  the 
world’s  history.  Many  circumstances  conspire  to 
produce  this  condition  of  things.  It  is  not  owing  to 
any  change  in  man’s  nature,  peculiar  to  this  age,  for 
human  nature,  without  doubt,  has  been  the  same  in 
every  enlightened  age  and  nation,  but  results  in  part 
from  the  higher  incentives  to  cultivation,  and  the 
greater  rewards  offered  to  industry.  Wherever 
these  are  liberally  provided,  there  every  faculty  of 
mind  and  body  will  be  exerted  to  the  utmost,  and 
man  will  furnish  the  most  numerous  and  shimmy 

o 

examples  of  human  perfection.  Besides,  along  with 
these  inducements  for  the  ardent  pursuit  of  useful 
knowledge,  we  are  the  fortunate  heirs  of  time,  who 
have  acquired  by  inheritance  all  the  advantages  of 
the  experience  and  wisdom  which  history  teaches. — 
Mounted,  as  it  were,  upon  the  shoulders  of  those 


12 


ADDRESS  ON  MALARIA. 


who  have  preceded  us  in  the  pathway  of  human  pro- 
gress, we  enjoy  a more  extended  horizon  than  met 
their  view.  No  narrow  limits  contract  the  sphere  of 
our  intellectual  vision,  but  the  whole  boundless  world 
is  ours. 

Much,  too,  is  due  to  Protestantism , which  has 
achieved  wonders  in  philosophy  as  well  as  religion, 
and  is  one  of  the  distinguishing  peculiarities  and 
most  valuable  characteristics  of  the  present  age.  In 
our  day,  the  inquirer  after  Catholic  truth,  in  all  the 
departments  of  knowledge,  in  the  exact  sciences  and 
speculative  philosophy,  as  in  religion,  can  pursue  his 
object  with  a protestant  spirit.  No  longer  the 
schools  are  connected  with  the  Vatican,  producing  a 
degree  of  mental  vassalage  and  subserviency  destruc- 
tive of  the  spirit  of  free  inquiry.  No  longer  the 
word  of  a Priest  or  Master,  or  a dogma  of  the 
schools,  is  the  test  of  truth,  but  the  immortal  mind, 
whose  capacity  for  knowledge  and  wisdom  is  increas- 
ed the  more  it  is  stored  with  useful  treasures,  is  left 
that  full  liberty  to  combat  error  or  pursue  truth, 
which  is  so  characteristic  of  the  age  we  live  in. — 
And  if  it  be  the  honor,  as  I believe  it  is,  as  well  as 
the  character,  of  this  age,  that  genius  and  learning, 
not  less  than  Christian  benevolence,  are  chiefly  busy 
in  the  habitations  of  men,  and  around  the  walks  of 
daily  life,  and  that  the  greatest  men,  as  well  as  the 
best,  find  their  themes  of  study,  and  their  sources  of 
inspiration,  in  the  moral  and  physical  wants  of  man- 


ADDRESS  ON  MALARIA. 


13 


kind,  then,  in  such  an  age,  and  especially  in  a coun- 
try like  ours,  where  we  have  in  our  govermental  po- 
licy avoided  the  cherished  prejudices  and  tolerated 
errors  of  long  established  despotism,  on  the  one 
hand,  and  escaped  from  the  greater  evils  of  fanati- 
cism, unrestrained  by  law,  on  the  other,  “he  who  will 
not  reason  is  a bigot,  he  who  cannot  reason  is  a fool, 
and  he  who  dares  not  reason  is  a slave?  God  has 
given  man  the  peculiar  faculty  of  reason  to  guide 
him  wisely,  and  therefore  safely,  in  the  pursuits  of 
life,  and  he  who  will  not  exercise  it  vigorously  and 
healthfully  in  the  progress  of  events,  will  presently 
find  himself  trodden  down  and  crushed  beneath  the 
feet  of  the  rushing  multitude  whose  onward  course 
he  obstructs.  Let  not  this  be  the  lot  of  any  one  of 
us.  On  the  contrary,  let  each  of  us,  not  only  in  his 
individual  character  and  position,  but  likewise  in  his 
associated  character,  press  on  to  the  attainment  of 
the  objects  and  purposes  of  his  high  calling,  emulat- 
ing the  lives  and  conduct  of  the  masters  in  our  pro- 
fession, who  have  taken  then-  stand,  shoulder  to 
shoulder,  in  the  foremost  ranks  with  those  philo- 
sophers who  have  inscribed  their  names  high  in  the 
temple  of  fame. 

In  the  anticipation  of  a glorious  future,  the 
youthful  and  ambitious  student  finds  the  highest  in- 
centive diligently  to  prepare  himself  for  the  active 
and  honorable  course  he  means  to  run  ; and  the  old- 
er ones  find  it  necessary  to  labor  faithfully  in  their 


14 


ADDRESS  ON  MALARIA. 


several  callings,  that  they  may  wear  the  honors  of 
experience  gracefully,  and  not  be  outstripped  by 
their  more  youthful  and  equally  well  informed  com- 
petitors. So,  as  there  is  no  privileged  road  to  know- 
ledge and  usefulness,  every  competitor,  whatever  his 
age  and  condition  in  life,  who  struggles  to  win  and 
wear  a distinction  worth  preserving,  must  undergo  the 
same  painful  discipline  of  mind  and  laborious  exer- 
tion. But  let  him  who  runs  take  heed  lest  he  fall, 
mistaking  the  feverish  excitement  and  fitful  energy 
of  a sanguine  temperament  for  a true  and  noble  am- 
bition, and  a momentary  popularity  for  lasting  re- 
nown. 

Such  is  the  study  and  practice  of  medicine,  and 
I am  persuaded  that  the  former,  if  carried  on  with  a 
full  knowledge  of  its  important  duties  and  relation- 
ships with  the  well  being  of  society,  is  ennobling 
in  its  very  nature  ; and  that  the  latter  is  honorable, 
and  will  be  remunerative,  when  conducted  under  the 
influence  of  that  preparation,  hopefulness,  and  pati- 
ence, which  enable  us  to  be  contented  with  small  be- 
ginnings, but  keep  us  always  ready  for  the  gradually 
widening  sphere  of  useful  labors  that  certainly  await 
us.  We  must  remember  though,  if  we  hope  to  suc- 
ceed, always  to  have  some  good  object  or  useful  pur- 
pose in  view ; and  even  in  our  moments  of  relaxa- 
tion from  the  severer  duties  and  arduous  labors  of 
our  profession,  not  to  turn  exactly  into  the  ‘ prim- 
rose path  of  dalliance,”  but  endeavor  to  cultivate  an 


ADDEE8S  ON  MALARIA. 


15 


acquaintance  with  those  kindred  sciences,  which  de- 
velop the  mental  faculties,  and  a taste  for  polite  liter- 
ature which  gives  them  harmony,  and  to  acquire  a 
Christian  spirit,  that  we  may  have  it  in  our  power  to 
contribute  to  the  refinements  as  well  as  happiness  of 
the  social  circle.  This  course  of  mental  gymnastics 
will  not  only  enable  us  to  investigate  with  facility 
and  to  scrutinize  the  advantages  and  disadvantages 
of  all  the  facts  and  theories,  which  are  continually 
coming  out  of  the  prolific  laboratories  of  medical 
Philosophers,  but  likewise  to  discharge  the  onerous 
duties  of  our  profession  more  as  a pleasure  than  as  a 
task. 

“ Ti«  not  for  mortals  io  command  success 
But  we’ll  do  more,  Sempronius, — we’Jl  deserve  it.” 

Lord  Bacon  regarded  the  science  of  medicine 
with  the  greatest  interest.  He  aimed  at  the  relief  of 
“man’s  estate,”  and  this  he  believed  was  to  be  ac- 
complished as  well  by  mitigating  human  suffering  as 
by  multiplying  human  enjoyment.  The  study,  there- 
fore, of  the  to  hilon  and  to  eidolon  of  the  old  philo- 
sophers, however  well  calculated  it  may  have  been  to 
sharpen  the  wit  or  refine  the  rhetoric  of  the  school- 
men, contributed  but  little,  according  to  the  views  of 
this  great  man,  to  alleviate  the  pains  or  lessen  the 
burdens  of  suffering  humanity.  Considered  in  rela- 
tion to  these  great  objects,  he  regarded  the  science  of 
medicine  as  the  most  important  department  of  know- 


16 


ADDEESS  ON  MALAEIA. 


ledge,  because  it  was  capable  of  conferring  the  most 
desirable  benefits  on  mankind. 

In  this  connection,  too,  it  will  not  be  improper 
to  elevate  our  thoughts  and  recollect  that  “ the  great 
physician  of  the  soul  did  not  disdain  to  be  also  the 
physician  of  the  body.” 

How  gratifying  to  the  mere  philanthropist  and 
physician  are  the  views  and  opinion  of  Bacon! — - 
How  cheering  and  sustaining  to  the  enlightened,  la- 
boring physician,  who  is  at  the  same  time  a Christian 
man,  to  know,  that  in  some  degree,  at  least,  he  is  fol- 
lowing the  example  of  his  Divine  Master  l 

Again  ; the  dangers  the  medical  man  encounters, 
and  encounters  alone,  unsupported  by  the  emulous 
spirit  and  confidence  of  numbers, 

“ All  the  while 

Sonorous  metal  blowing  martial  sounds,” 

are  as  much  greater  than  those  of  the  soldier  in  the 
battle  field,  as  the  calm  deliberation  of  high  purpo- 
ses and  conscious  rectitude  is  superior  to  the  mere 
enthusiasm  of  excited  courage.  Aye,  and  if  he  falls, 
as  he  oftentimes  does,  fighting  with  deadly  disease,  in 
his  lonely  walks  amidst  pestilence  and  famine,  no  fu- 
neral honors  attend  upon  him,  no  public  provisions 
await  his  family.  His  is  the  honor  only  to  have  act- 
ed well  the  things  that  belong  to  the  sad  realities 
and  pressing  necessities  of  human  life — his  the  honor 
to  have  been  a co-worker  with  those  great  and  good 
men,  by  whose  constant  toils,  and  energetic  labors 


ADDRESS  ON  MALARIA. 


17 


and  self-sacrificing  spirits,  mankind  have  been  ever 
blessed ! Hence  it  is  with  some  assurance,  although 
with  an  humble  spirit,  I assert,  that  the  diligent 
and  enlightened  pursuit  of  so  honorable  a calling 
as  ours,  for  honest  purposes,  is  faithfully  to  se^ve 
God. 

But  I must  turn  from  this  agreeable  theme,  and 
the  further  elucidation  of  it,  inviting  as  it  is,  and  di- 
rect your  attention  to  the  proper  subject  of  this  es- 
say, in  which  I propose  to  discuss  the  doctrine  of 

THE  MIASMATIC  ORIGIN  OF  DISEASE. 

The  acquisition  of  as  complete  and  perfect  a 
knowledge  of  the  causes  of  disease,  as  may  be  attain- 
able, is  so  obviously  useful  to  the  general  practition- 
er, that  it  will  not  be  necessary  for  me  to  insist  upon 
it  here  ; for,  although  the  nature  and  seat  of  the  ma- 
lady be  equally  well  known,  and  the  method  of 
treatment  thoroughly  understood,  it  is  nevertheless 
of  great  importance  to  be  able  to  refer  to  its  cause, 
which,  indeed,  after  giving  rise  to  the  disease,  may 
still  continue  to  operate  injuriously  by  its  presence. 
Now,  as  this  is  especially  true  of  that  class  of  disor- 
ders, commonly  denominated  malarions  or  miasmatic 
diseases ; and  as  these  diseases  and  their  causes  should 
be  particularly  objects  of  study  and  inquiry  with 
many,  if  not  most,  of  the  physicians  of  North  Caro- 
lina, I shall  assign  no  other  reason,  because  I believe 
I can  adduce  no  higher  one,  for  making  their  Etiolo- 


18 


ADDRESS  ON  MALARIA. 


gy  the  subject  of  this  communication.  On  the  other 
hand,  I do  not  mean  to  he  prevented  from  express- 
ing my  opinion  in  the  premises,  because  it  is  too  com- 
monly the  case,  that  he,  who  undertakes  to  direct  the 
professional  or  public  mind  to  objects  of  etilogical 
reform,  is  more  apt  to  be  considered  a visionary  the- 
orist, than  a zealous  and  intelligent  advocate  of  sani- 
tary improvements.  Nor  shall  I bring  forward,  just 
now,  any  other  theory  to  explain  these  phenomena, 
as  an  excuse  or  apology  for  what  I have  to  say  in  op- 
position to  the  received  notions  upon  this  subject. — 
Entertaining,  as  I do,  the  firm  conviction,  that  the 
first  important  step  in  a practical  investigation  is  the 
removal  of  any  error  with  which  it  may  be  encum- 
bered, it  is  sufficient  for  my  present  purpose,  what- 
ever my  ultimate  intention  may  be,  to  show  that 
marsh  miasm,  in  the  sense  of  an  exhalation  from  pu- 
trescent vegetable  matter,  cannot  be  the  cause  of  dis- 
ease. And,  indeed,  it  would  not  be  a difficult  matter 
ito  bring  forward  evidence  to  prove  that  if,  instead  of 
fitting  down  quietly  under  the  persuasion  of  the  ex- 
istance  of  this  thing,  maish  miasm,  an  inappreciable 
essence,  about  which  they  cannot  agree,  medical  men 
and  the  civil  authorities  would  earnestly  and  wisely 
exert  themselves  to  discover  the  real  nature  and  sour- 
ces of  morbific  agents,  the  result  would  be  an  aston- 
ishing diminution  of  the  liabilities  to  disease  and  the 
rates  of  mortality.  It  is  apparent,  therefore,  in  re- 
gard to  this  question,  that  I consider  it  one  of  s me 

o 


ADDRFSS  ON  MALARIA. 


19 


little  importance,  at  least,  to  the  skilful  physician  of 
the  Southern  States,  involving,  as  it  does,  the  every 
day  application  almost  of  the  principles  of  practical 
etiology,  which  I understand  to  be  the  establishment 
of  the  invariable  relationship,  as  cause  and  effect,  of 
those  agents  or  influences  that  are  capable  of  produc- 
ing diseases,  and  the  diseases  themselves.  This,  I 
believe,  the  sequel  will  show  is  not  the  case  with  mi- 
asm and  the  so-called  miasmatic  diseases. 

I know  that  in  advancing  this  opinion,  I am  im- 
pinging upon  the  current  prejudices  and  dogmas  of 
the  schools,  and,  perhaps,  upon  the  opinions  of  most, 
if  not  all,  of  the  medical  gentlemen  here  assembled. 
But,  let  me  ask  you,  in  all  sincerity,  have  you  not 
adopted,  as  a portion  of  your  early  professional  edu- 
cation, your  belief  in  the  miasmatic  origin  of  disease  ? 
Have  you  faithfully  and  philosophically  investigated 
its  claims  to  validity  and  truth,  and,  after  due  inqui- 
ry, yielded  it  your  full  credence,  because  you  could 
not  resist  the  overwhelming  evidence  in  its  favor  ? 
Or  have  you  not  unpardonably  cherished  an  error, 
because  it  was  a popular  one,  or  because  it  furnished 
you  with  an  easy,  if  not  satisfactory,  solution  of  a 
difficult  question  ? Or  have  you  not  preferred  to 
rest  on  a foregone  conclusion,  not,  at  bottom,  really 
embracing  any  well  tried  fact,  or  established  principle, 
rather  than  be  troubled  or  disturbed  about  that  on 
which  you  have  already  made  up  your  minds  ? Or, 
acting  still  more  culpably,  and  upon  the  well  known 


20 


ADDRESS  ON  MALARIA. 


maxim  of  Bolingbroke,  “ that  whilst  plain  truth 
may  influence  half  a score  of  men,  mystery  will  lead 
millions  by  the  nose,”  have  not  medical  men,  from  the 
days  of  Lancisi  down  to  the  present  time,  used  the 
term  miasm  or  malaria  as  a sort  of  convenient  cloak 
for  covering  up  their  real  want  of  information  upon 
this  subject,  and  thus  hiding  their  ignorance  from  the 
public  gaze  ? And  is  this  the  proper  method,  think 
you,  of  conducting  an  investigation  after  truth,  rea- 
sonable truth,  especially  by  those  who  seek  it  for  the 
ennobling  purpose  of  remedying  the  “ ills  that  flesh 
is  heir  to?”  Surely  not.  For,  after  all,  the  expres- 
sion, marsh  miasm,  as  denoting  the  cause  of  disease, 
is  nothing  more  than  a mere  theoretical  way  of  an- 
nouncing the  fact  that  something  exists  of  the  nature 
and  source  of  which  we  are  ignorant,  for  the  produc- 
tion of  these  diseases,  since  it  can  neither  be  appre- 
ciated by  our  senses  in  their  natural  state,  nor  aided 
by  all  the  artificial  contrivances  which  ingenuity 
can  suggest,  nor  traced  even  by  the  presence  of 
those  agencies  which  are  said  to  be  capable  of  gener- 
ating it. 

Educated  to  believe,  with  entire  confidence,  in 
the  theory  of  the  miasmatic  origin  of  disease,  it  was 
not  long  after  I commenced  the  practice  of  my  pro- 
fession in  one  of  the  paludal  districts  of  this  State, 
before  I began  to  doubt  the  sufficiency  of  the  facts 
and  arguments  upon  which  the  doctrine  rested. — 
Subsequent  observations,  and  a more  enlarged  and 


ADDRESS  ON  MALARIA. 


21 


matured  experience,  have  ripened  those  doubts  into 
convictions,  and  I now  regard  the  doctrine  as  a 
groudless  assumption  or  pure  hypothesis.  Let  me 
not,  however,  be  misunderstood  on  these  points.  I 
do  not  mean  to  deny  the  fact,  well  known  to  every 
observing  man,  whether  he  be  a physician  or  not, 
that  a low  marshy  country  is,  generally  speaking, 
more  sickly  than  a higher,  drier  and  better  ventila- 
ted one.  Indeed,  I may  observe  in  this  connection, 
that  so  far  from  denying  the  effect  of  climate  and  po- 
sition upon  organic  life,  I am  inclined  to  think  there 
is  some  truth  in  the  remark  of  a distinguished  natu- 
ralist, made  at  a meeting  of  Savans  in  Charleston, 
South  Carolina,  a year  or  two  ago,  that  he  was  so 
well  acquainted  with  the  geological  and  meteorologi- 
cal conditions  of  the  State  in  which  he  resided,  and 
the  influences  they  exerted,  even  upon  man,  as  to  be 
able1  to  decide  in  a given  number  of  individuals,  by 
their  peculiar  characteristics,  in  what  sections  of  the 
State  a majority  of  them  were  reared.  Nor  do  I 
mean  to  assert,  what  every  educated  person  will  deny, 
that  hypotheses  are  altogether  valueless  in  every  sci- 
entific inquiry.  The  views  I wish  to  present,  and 
hope  to  maintain,  are  simply  these : That  the  greater 
sickliness  of  the  low  lands  is  not  owing  to  miasm,  an 
exhalation  from  decaying  vegetable  matter,  under 
certain  circumstances  of  heat  and  moisture,  the  sense 
in  which  it  is  used  by  the  schoolmen ; and  that  hypo- 
theses, to  be  of  an}’'  importance  in  philosophical  in- 


22 


ADDRESS  ON  MALARIA. 


vestigations,  must  have  such  a fixed  and  determinate 
value  as  will  always  render  them  applicable  under 
like  circumstances,  and  inapplicable  under  dissimilar 
ones.  Locke  says : “ Hypotheses,  if  they  are  well 
made,  are  at  least  great  helps  to  the  memory,  and  of- 
ten direct  us  to  new  discoveries.”  But  at  the  same 

l* 

time,  he  gives  us  the  wholesome  caution,  “ that  the 
name  of  principles  deceive  us  not,  nor  impose  on 
us,  by  making  us  receive  that  for  an  unquestionable 
truth,  which  is  really  at  best  but  a very  doubtful 
conjecture.” 

Sir  Isaac  Newton  says:  “For  the  best  and  sa- 
fest method  of  philosophizing  seems  to  be,  first,  to 
inquire  diligently  into  the  properties  of  things,  and 
establish  those  properties  by  experiments,  and  then 
to  proceed  more  slowly  to  hypotheses  for  the  expla- 
nation of  them.”  But,  lest  it  may  be  said  that  New- 
ton had  reference  to  the  exact  science  of  mathema- 
tics, listen  to  the  language  of  Sir  H.  Davy,  to  whose 
particular  department  of  philosophical  knowledge, 
chemistry,  this  subject  of  miasmata  properly  belongs. 
He  says : “ I trust  that  our  philosophers  will  attach 
no  importance  to  hypotheses,  except  as  leading  to  the 
research  after  facts,  so  as  to  be  able  to  discard  or 
adopt  them  at  pleasure,  treating  them  rather  as  parts 
of  the  scaffolding  of  the  building  of  science,  than  as 
belonging  to  its  foundation,  materials  or  ornaments.” 
It  is  not  my  purpose,  then,  altogether  to  condemn 
hypotheses,  but  to  keep  them  in  their  proper  places, 


ADDRESS  ON  MALARIA. 


23. 


to  render  them  subordinate  to  the  laws  which  should 
regulate  all  inquiries  in  the  physical  sciences.  For 
example,  to  assume  that  miasm  was  the  cause  of  dis- 
ease, the  existence  of  which  is  only  inferred  from  the 
faet  that  disease  prevails  under  circumstances  totally 
inexplicable,  unless  upon  the  assumption  of  the  exis- 
tence of  such  a cause,  would  not  be,  I apprehend,  an 
improper  method  of  philosophizing,  provided,  on  the 
one  hand,  we  always  had  the  circumstances  present 
which  were  claimed  as  being  capable  of  generating 
the  cause  itself,  and,  on  the  other  hand,  the  disease 
invariably  following  as  a matter  of  consequence. — 
Under  different  circumstances,  that  is,  in  the  absence 
of  either  the  disease  or  the  miasm,  we  should  have  a 
cause  without  its  corresponding  effect,  or,  what  would 
be  a much  worse  state  of  things  in  physics,  because 
fatal  to  any  theory  of  causation,  an  effect  without  a 
cause. 

Now,  the  course  of  nature,  so  far  as  it  has  been 
observed  and  is  cognizable  by  our  senses  directly,  or 
indirectly,  where  we  have  been  able,  by  the  aid  of 
artificial  contrivances,  carefully  to  observe  her  laws-, 
and  operations,  is  so  uniform  in  respect  to  causes,  ancb 
effects,  and  so  specific  in  the  character  of  her  laws, 
that  we  are  bound  by  a correct,  philosophy  to  refer 
the  phenomena  of  disease  to  some  one  or  more  of  the 
appreciable  states  of  the  surrounding  media,  which 
are  in  any  way  brought  into  relationship,  with  our 
bodies,  or  to  intelligible  internal  agencies,,  or  systemic 


24 


ADDRESS  ON  MALARIA. 


influences,  rather  than  to  some  unknown,  fanciful  and 
inappreciable  condition  of  the  atmosphere. 

It  is  my  purpose,  therefore,  in  the  course  of  my 
remarks,  to  show  that  the  doctrine  of  the  miasmatic 
origin  of  disease  does  not  rest  on  the  Evidence  of  our 
senses,  aided  or  unaided,  or,  indeed,  upon  reliable  evi- 
dence of  any  kind  ; but  that  it  falls  under  the  absur- 
dity alluded  to  above,  namely,  of  a cause  without  a 
consequence,  or  a consequence  without  a cause. — 
Hence,  the  conclusion  to  which  I have  come,  with 
others,  that  this  theory  is  a groundless  ssumption,  un- 
supported by  such  facts  and  principles  as  should  con- 
stitute the  basis  of  every  philosophical  inquiry. 

In  mathematics,  you  cannot  rightfully  seek,  much 
less  command,  a demonstration,  without  a suitable 
basis  of  established  facts  or  admitted  axioms.  So, 
every  legitimate  argument  and  philosophical  investi- 
gation should  rest  upon  facts  and  principles  that  are 
capable  of  application  under  like  circumstances,  in 
every  process  of  reasoning  by  which  the  inquiring 
mind  desires  to  establish  truth.  But  for  the  very 
reason  that  like  circumstances  are  absolutely  necessary 
for  the  proper  display  ot  these  prerogative  facts  and 
principles,  it  is  obviously  the  case,  that  they  are  inap- 
plicable in  any  reasoning  or  argument  by  which  it 
may  be  attempted  to  account  for  the  same  phenome- 
na under  dissimilar  ones. 

This  statement  comprises  the  theory  of  induc- 
tion, and  if  medicine  be  entitled  to  a place  among  the 


ADDRESS  ON  MALARIA. 


25 


inductive  sciences,  then  is  the  principle  here  laid  down 
of  importance  to  our  inquiry ; for,  as  every  investiga- 
tion of  natural  phenomena  necessarily  becomes  an  in- 
quiry into  causes  and  their  effects,  and  unavoidably 
leads  to  a series  of  physical  laws,  so  every  well- 
grounded  theory  of  causation  must  have  an  intimate 
connection  with  the  theory  of  induction,  as  practised 
in  the  natural  sciences.  Induction,  then,  gives  us  the 
right  to  expect  that  the  same  result  will  always  hap- 
pen from  the  same  cause,  operating  under  like  cir- 
cumstances ; but  it  is  of  the  very  essence  of  this  in- 
ference that  the  similiarity  be  first  shown.  Without 
it,  no  process  of  induction  can  be  brought  to  a lawful 
conclusion,  and  reason,  right  reason,  cannot  be  the 
ground  of  our  belief. 

Moreover,  upon  what  does  our  idea  of  causation 
rest?  Unquestionably,  the  uniform  observance  of 
two  facts  or  sequences  of  external  nature  furnishes  us 
the  only  evidence,  a priori,  of  causes  in  that  sphere. 
The  conjunction,  therefore,  of  any  two  successive 
events  may  very  properly  become  the  ground  of  our 
belief  in  their  relationship  as  cause  and  effect,  provi- 
ded the  second  event  has  always  been  found  not  only 
to  follow  the  first,  but  the  second  must  never  have 
been  observed  without  the  first  preceding  it. 

Mill,  in  his  admirable  treatise  on  causation,  de- 
fines “ the  cause  of  a phenomenon  to  be  the  antece- 
dents upon  which  it  is  invariably  and  unconditional- 
ly consequent.”  And  again : “ Invariably  sequence, 


ADDRESS  ON  MALARIA. 


M 

therefore,  is  not  synonymous  with  causation,  unless 
the  sequence,  besides  being  invariable,  is  uncondi- 
tional.” 

Inconsiderately  Viewed,  this  absolute  law  of  cam 
sation,  whose  property  and  requirements  are  not  only 
Invariable  uniformity,  but  unconditional  consequence, 
might  appear  to  shackle  our  experimental  inquiries, 
by  narrowing  down  the  proof  too  rigidly;  but  a mo* 
ment’s  reflection  will  satisfy  us  that  such  is  not  the 
vase,  as  the  constituent  elements  of  a law  in  the  sci- 
ence of  physical  etiology,  the  subject  under  inquiry, 
ought  Hot  to  differ  from  those  of  a law  in  the  physi- 
cal sciences  generally — -that  is,  so  far  as  the  analysis 
has  reference  to  the  constancy  of  a phenomenon,  or 
the  invariableness  of  a relationship.  For,  let  it  be 
remembered  that  we  are  investigating  natural  pheno- 
mena, and  that  every  such  inquiry  is  a search  after 
causes  and  effects,  and  not  a study  of  the  calculus  of 
probabilities,  whose  loose  and  too  hasty  system  of 
generalization,  attempting  to  define  the  complex  be- 
fore the  simple  is  faithfully  learned,  has  led  medical 
minds,  loaded  with  hypotheses,  into  endless  vagaries 
and  absurdities  in  their  speculations  upon  the  subjects 
of  practical  etiology.  Recollect,  too,  that  nature 
in  her  course  is  always  uniform  and  certain,  and  that 
her  order  and  economy  are  such  as  never  to  employ 
the  wasteful  expenditure  of  two  separate  and  distinct 
causes  to  accomplish  one  and  the  same  object,  al- 
though in  a series  of  events  some  one  leading 


ADDRESS  ON  MALARIA. 


21 


phenomenon  may  be  the  chief  cause  of  many 
consequences  , and  it  will  be  clearly  seen  that 
these  principles  are  not  too  rigid  for  a correct 
philosophy. 

Now  let  us  apply  this  Baconian  process  of  in- 
ductire  reasoning,  this  well  established  method  of 
conducting  philosophical  investigations,  to  our  belief 
in  the  miasmatic  origin  of  malarious  diseases,  and  see 
if  it  is  well  founded.  Or  whether,  in  the  first  place, 
we  have  not  assumed  a fact,  which  is  not  proved,  and 
then  built  upon  it  a theory,  which,  in  the  next  place, 
we  are  prone  to  apply  when  no  induction  or  proper 
plan  of  philosophizing  shows  that  it  is  applicable  ; 
thus  making  the  whole  operation  not  a process  of  in- 
ference or  induction,  but  one  of  interpretation  or  de- 
duction, which  is,  after  all,  the  old  Syllogistic  method 
of  teaching  by  authority,  rather  than  according  to 
the  rules  of  modern  philosophy,  which  has  discover-* 
ed  the  only  true  method  of  scientific,  investigation, 
by  making  facts  the  basis  of  inductions.  To  take 
these  constructive  formulas  or  syllogisms  for  the  re- 
alities of  experience  and  observation  was  the  grand 
folly  of  the  ancients.  To  employ  them  without  due 
examination  as  to  their  real  value  and  scientific  ap^ 
plicability  is  the  besetting  pedantry  of  many  mo-1 
derns,  especially  wrangling  theologians,  who  attempt 
to  make  the  wisdom  and  laws  of  Omnipotence  quad- 
rate with  their  finite  notions  and  pre-conceived  opi- 
nions. Carefully  investigated,  then,  I think  it  will  be 


28 


ADDRESS  ON  MALARIA. 


clearly  seen  that  medical  men  have  been  reasoning 
backwards,  as  it  were,  upon  this  subject  of  miasm, 
and  that,  too,  without  sufficient  data  to  conduct  them 
to  a legitimate  conclusion,  whilst  the  rules  of  a just 
and  well  grounded  philosophy  require  of  them  not 
only  to  prove,  first,  the  existence  of  the  facts  of  the 
case,  and  their  invariable  relationships,  but  secondly, 
that  they  shall  not  reason  from  such  facts,  in  an  ex- 
planation of  any  phenomena,  excepting  under  like  cir- 
cumstances. 

It  might  be  well  worth  my  while  to  dwell  lon- 
ger upon  this  important  principle,  if  I had  the  time, 
instead  of  apologizing  for  the  length  of  this  prelimi- 
nary discussion,  as  the  neglect  of  it  is  an  error  very 
generally  prevailing  with  medical  men,  as  well  as 
others,  and  one  which  leads  to  an  exceedingly  loose 
and  careless  kind  of  inquiry ; but  I must  pass  on  to 
the  consideration  of  my  subject  more  in  detail,  trust- 
ing that  the  array  of  facts  and  lawful  inferences, 
which  I shall  adduce  in  support  of  my  position,  will 
at  least  awaken  the  spirit  of  inquiry  in  your  minds, 
if  they  do  not  satisfy  you  of  its  entire  correctness. 

But,  for  the  purpose  of  doing  this  in  a somewhat 
systematic  manner,  it  will  be  necessary  for  me  to  state 
clearly,  first,  what  is  understood  by  the  word  miasm 
or  miasmata,  in  the  sense  in  which  it  is  used  by  those 
who  invoke  its  aid  in  the  causation  of  diseases  ; and 
secondly,  to  demonstrate  the  fallacy  of  the  doctrine, 
by  showing  ive  have  no  satisfactory  proof  that  the  mor- 


ADDRESS  ON  MALARIA. 


29 


Ufic  cause  of  what  are  called  miasmatic  diseases  arises 
from  vegetable  putrefaction. 

Under  the  first  head,  I shall  make  a few  perti- 
nent extracts  from  different  authors,  to  show  the  sense 
in  which  the  word  miasm  or  miasmata  is  used,  and 
what  is  understood  by  them  to  be  the  source  of  this 
febrific  agent.  These  might  be  multipled  without 
number,  but  as  there  does  not  prevail  much  difference 
of  opinion  among  the  miasmatists  upon  this  subject, 
it  is  quite  unnecessary. 

Bancroft  informs  us  that  a humid  soil,  abound- 
ing in  vegetable  remains,  and  acted  on  by  heat, 
the  range  of  which  is  from  45  to  100  Fahrenheit, 
is  the  most  favorable  for  the  extrication  of  mias- 
mata. 

Dr.  Charles  Caldwell,  of  Transylvania  Uni- 
versity, in  a prize  essay  upon  the  subject  of  miasm, 
expresses  the  following  opinion  as  to  the  disease  pro- 
ducing properties  of  decomposing  vegetable  matter  : 
“Is  the  city  commercial,  and  situated  on  navigable 
water?  Let  not  the  wharves  be  built  entirely  of 
wood.  Their  facing,  at  least,  should  consist  of  stone 
or  brick,  else  they  will  become,  in  time,  masses  of 
dissolving  vegetable  matter,  and  abundant  sources  of 
febrile  miasm.  That  the  cities  in  the  United  States 
suffer  in  their  health  from  this  cause,  cannot  be  doubt- 
ed. Piles  of  decaying  timber,  alternately  wet  and 
dry,  and  exposed  to  the  ardor  of  an  American  sum- 
mer sun,  must  produce  malaria  as  certainly  and  as  na- 


30 


ADDRESS  ON  MALARIA. 


turally  as  the  influence  of  spring  promotes  vegetation, 
and  the  rigors  of  winter  suspend  it.” 

Dr.  Eberle,  article  miasmata,  assures  us  that, 
“ Whenever  vegetable  matter  meets  with  suffici- 
ent heat  and  moisture  to  cause  it  to  enter  into 
humid  decomposition,  there  miasmata  will  be  evolv- 
ed,” &c. 

Clymer,  in  his  “ Treatise  on  Fevers,”  declares : 
“ Whatever  its  constitution  or  essence  may  be,  it  at 
any  rate  appears  evident,  that,  in  order  to  its  produc- 
tion, there  must  be  present  a certain  quantity  of  mois- 
ture, vegetable  matter  in  a state  of  decomposition,  and 
a warm  temperature.” 

Professor  Wood,  of  the  University  of  Pennsyl- 
vania, in  his  work  on  the  practice  of  medicine,  arti- 
cle miasma,  observes  that,  “ So  strong  indeed  is  the 
evidence  of  this  fact,  that  the  great  mass  of  observers, 
ever  since  the  time  of  Lancisi,  have  agreed  and  still 
agree,  in  ascribing  the  miasmatic  influence,  whatever 
may  be  its  nature,  to  organic  and  especially  vegetable 
decomposition.” 

Agreeable  to  Elliotston,  a distinguished  prac- 
titioner of  London:  “ The  exciting  cause  of  ague,  the 
true  indispensable  cause  of  it,  I believe  to  be  an  ex- 
halation from  decaying  vegetable  matter ;”  and  that 
“ a certain  degree  of  moisture  is  necessary  for  the  fer- 
mentation and  putrefaction  of  vegetable  matter, 
which  fermentation  and  putrefaction  give  rise  to  the 
exhalations  which  produce  ague.”  Whilst  McCul- 


ADDRESS  ON  MALARIA. 


31 


lock,  who  stands  at  the  head  of  the  miasmatists, 
in  his  Treatise  on  Malaria,  arrives  at  the  opinion, 
“That  the  presence  of  vegetables  or  vegetable  mat- 
ter, in  some  mode  or  form,  is  necessary  to  the  extri- 
cation of  malaria ; while  the  conclusion  has  some- 
times been,  that  it  is  a production  formed  between 
the  living  vegetable  and  water  ; more  generally  that 
it  is  generated  between  that  and  the  latter,  in  some 
stage  intermediate  between  life  and  absolute  decom- 
position ; or  lastly,  that  it  is  the  consequence  of  ab- 
solute putrefaction.” 

From  the  above  extracts,  which  have  been  se- 
lected without  much  care,  it  will  be  seen  that  miasm 
consists  mainly,  if  not  entirely,  of  an  exhalation  from 
decomposing  vegetable  matter,  under  such  circum- 
stances of  heat  and  moisture  as  are  capable  of  produ- 
ing  putrefaction. 

Now,  as  it  is  not  necessary  for  the  object  of  this 
investigation  that  I should  stop  here  to  inquire  into 
the  slight  differences  in  opinion  amongst  the  miasma- 
tists, as  to  the  specific  amount  of  heat,  moisture,  and 
vegetable,  or  organic  matter,  which  it  is  necessary 
to  have  for  the  purpose  of  evolving  this  subtile  poi- 
son,— since  we  may  very  naturally  conclude,  we  shall 
have  the  greater  product,  the  more  material  we  have 
out  of  which  to  form  it,— I shall  proceed  at  once  to 
show,  under  the  second  head , by  extracts  from  the 
most  reliable  authors,  and  by  adducing  instances  of 
undoubted  truth,  that  we  may  have  miasmatic  disea- 


32 


ADDRESS  ON  MALARIA. 


ses  prevailing  in  situations  so  totally  different  from 
each  other,  it  is  impossible,  under  the  rules  of  a cor- 
rect philosophy,  to  ascribe  them  to  effluvia  from  de- 
caying vegetable  matter.  In  other  words,  that  we  are 
sometimes  exempt  from  them  where  vegetation  and  de- 
caying vegetable  matter,  together  with  heat  and  mois- 
ture, sufficient  to  produce  putrefaction,  are  abundant, 
and  then,  again,  have  them  committing  fearful  rava- 
ges, where  there  is  no  vegetable  matto  decay,  and 
where  there  is  no  moisture  to  aid  putrefaction. 

Dr.  Drake,  in  his  work  on  the  principal  disea- 
ses of  the  valley  of  North  America,  speaking  of  the 
Miami  valley  says : “ The  upper  portions  of  this  ba- 
sin abound  in  wet  and  marshy  prairies,  woodland 
swamps,  and  ponds,  or  small  lakes  of  pure  water. — 
The  Southern  portions  offer  but  little  of  either  on  the 
uplands ; but  in  the  wide  valleys  of  both  the  Miani- 
ies  and  along  all  their  larger  tributaries  every  variety 
of  wet  surface  was  found  in  spring  and  early  summer, 
when  settlements  were  first  made  : by  clearing,  culti- 
vation and  draining,  however,  a much  drier  condition 
has  been  produced.  At  the  same  time,  mill-ponds 
have  generally  multiplied,  and  two  canals,  one  from 
Cincinnati  to  Dayton,  and  thence  to  Lake  Erie,  and 
the  other  from  the  former  city  to  Brookville,  and 
Cambridge,  in  the  State  of  Indiana,  have  been  exca- 
vated. In  the  month  of  June,  they  are  annually 
emptied  of  water,  and  the  mud  accumulated  in  the 
bottoms  is  scraped  out  upon  their  banks.”  * * * 


ADDRESS  ON  MALARIA. 


38 


“ Through,  the  whole  distance,  it  (the  canal  to 
Dayton,)  traverses  a fertile  valley  from  one  to  three 
miles  in  width,  abounding  in  diluvial  terraces  and 
low  alluvial  bottoms,  to  which  the  present  diminu- 
tive stream  bears  in  the  volume  of  its  waters  no  as- 
signable proportions.  This  valley  is,  in  fact,  the  ob- 
solete bed  of  one  of  those  vast  river  currents  which 
once  flowed  from  the  north  into  the  trough  of  the 
Ohio  river.” 

Here  we  unquestionably  have  an  abundance  of 
the  materials,  heat,  moisture,  and  vegetable  matter, 
for  the  generation  of  miasm  ; and  yet  the  same  wri- 
ter, who  has  furnished  us  with  the  above  description, 
declares : “ It  does  not  appear  that  the  inhabitants  of 
the  region  through  which  the  canals  were  dug  were 
injured  by  the  process,  or  by  letting  in  the  water 
when  they  were  finished ; nor  have  I been  able 
to  collect  any  reliable  evidence,  that  the  annual 
emptyings  and  cleanings  out  have  been  productive  of 
fever.” 

Again,  on  the  authority  of  Dr.  Henton,  he  as- 
sures us,  there  is  on  Paint  Creek,  in  Ohio,  a mill 
pond  covering  over  sixty  acres  of  bottom  land,  near 
the  village  of  Washington,  which  is  generally  drained 
off  about  the  first  of  June,  after  having  been  sub- 
merged  all  the  previous  autumn,  winter,  and  spring, 
and  yet  it  was  never  known  to  cause  sickness  in  the 
neighborhood. 

The  following  facts,  communicated  to  me  by  my 
3 


34 


ADDRESS  ON  MALARIA. 


preceptor  and  friend,  Dr.  W.  C.  Warren,  respect- 
ing Dr.  T.  D.  Warren’s  mill-pond,  which  covers 
many  acres  of  ground,  and  dams  up  the  water  for 
a considerable  distance,  bear  directly  upon  this  ques- 
tion. “In  1846,”  says  Dr.  Warren,  “ this  mill-dam, 
four  miles  from  Edenton,  was  broken,  by  a very  large 
fall  of  rain,  on  the  4th  day  of  August.  All  the  wa- 
ter was  discharged  in  a few  days,  and  left  the  bottom 
of  the  pond  exposed  to  a very  hot  sun,  during  that 
month  and  September.  I expected  to  see  a regular 
pestilence  among  the  negroes,  who  number  more  than 
a hundred,  and  reside  within  two  or  three  hundred 
yards  of  the  mill,  but,  to  my  surprise,  there  was  less 
sickness  on  the  plantation  that  fall,  than  usual. — 
Since  1846,  the  dam  was  broken  in  the  summer  a se- 
cond time,  and  the  pond  has  dried  up  nearly  every 
year,  during  the  hot  months,  without  producing  more 
sickness  than  was  to  be  found  on  any  other  planta- 
tion of  the  same  size  in  the  country.” 

From  Dr.  Tilton  we  learn  that  the  town  of 
Lewes,  on  Cape  Henlopen,  Delaware,  although  com- 
pletely surrounded  by  marshes,  is  remarkably  salu- 
brious, and  a sort  of  sanatorium  for  those  invalids  of 
the  surrounding  country  who  have  enlargement  of 
the  spleen  and  obstructed  viscera,  from  fevers. 

Pensacola  bay  is  several  miles  in  extent,  and 
bounded  on  the  West  side,  from  the  Gulf  coast  up 
to  its  head,  wdth  sand  beach  of  limited  extent,  in  the 
midst  of  which  are  found  marshes  of  fresh  water 


ADDRESS  ON  MALARIA. 


35 


covered  with  cypress,  magnolia,  sub-aquatic  plants 
and  shrubs,  yet  it  is  quite  healthy,  excepting  near  the 
head  of  the  bay,  where  the  Escambia  river,  com- 
ing down  from  Alabama,  empties.  Here  it  has  been 
notoriously  sickly  always,  notwithstanding  the  tem- 
perature and  moisture  are  the  same  as  they  are  low- 
er down  the  bay,  and  the  extent  of  marsh  only  a 
trifle  greater. 

My  present  object  does  not  make  it  necessary 
for  me  to  describe  particularly  the  topography  of  the 
Delta  of  the  Mississippi,  further  than  to  state,  what 
every  one  knows,  that  it  consists  of  alluvial  deposits, 
with  an  abundant  and  luxuriant  vegetable  growth. — 
Such  a condition  of  things,  in  so  hot  a climate,  might, 
a priori,  be  claimed  by  the  miasmatist  as  the  very  fo- 
cus of  miasms ; but  let  us  see  what  are  the  opinions 
of  some  distinguished  medical  gentlemen,  themselves 
believers  in  the  doctrine  of  the  miasmatic  origin  of 
disease,  upon  this  subject. 

The  inhabitants  of  the  Balize,  writes  Dr.  Drake, 
suffer  much  less  from  miasmatic  diseases  than  those 
who  reside  along  the  rivers  of  the  interior  of  Louisi- 
ana, notwithstanding  vegetation,  heat  and  moisture 
are  as  abundant  at  the  Balize  as  more  inland.  This 
he  and  others  attempt  to  explain,  by  supposing  that 
the  salt  water  of  the  Gulf  waves  prevents  the  extri- 
cation of  miasmata  at  the  Balize.  The  same  reason 
is  given  for  the  comparative  healthfulness  of  Key 
West;  and  also  to  explain  why  Fort  Pike  is  less  lia- 


36 


ADDRESS  ON  MALARIA. 


He  to  malarious  diseases  than  Fort  Wood;  but  it 
will  be  seen  presently  from  the  statements  of  Mar- 
ciietti,  that  whatever  sanitary  properties  salt  water 
may  have  in  this  country,  under  such  circumstances, 
it  has  no  such  virtues  in  Italy.  As  to  the  influence 
of  salt  water  in  preserving  the  health  of  marshy 
places,  Marchetti,  in  his  medical  topography  and  sta- 
tistics of  the  Tuscan  Maremma,  speaking  of  the  cause 
of  the  fever,  is  decidedly  of  opinion,  that  “ the  mix- 
ture of  salt  -with  fresh  water  greatly  increases  the  in- 
tensity of  the  miasms,  because  pestiferous  marshes 
have  become  innocuous  as  soon  as  the  ingress  of  salt 
water  has  been  prevented.”  He  gives  instances  of 
this  fact, — one  in  particular.  Hear  Yiareggio,  a nice 
and  pleasant  little  town  has  sprung  up,  and  is  used  as 
a retreat,  or  watering  place,  in  those  very  months 
when  it  was  formerly,  or  before  the  salt  water  was 
shut  off  from  its  marshes,  almost  pestilential.  In  a 
word,  he  insists  that  the  cause  of  fever  in  the  Marem- 
ma is  an  emanation  from  decomposing  animal  matter 
in  the  marshes,  and  that  the  “ humidity  of  the  at- 
mosphere, vegetable  decomposition,  and  changes  of 
temperature,  are  only  auxiliaries,  as  these  conditions 
are  to  be  found  in  districts  not  subject  to  intermit- 
tent and  remittent  fevers.” 

Dr.  Eberle,  one  of  our  standard  writers  upon 
such  subjects,  confirms  this  statement  of  Marchetti, 
upon  the  opinion  of  Monfalcon,  and  his  own  obser- 
vation. He  says : “ A mixture  of  fresh  and  salt  wra- 


ADDRESS  ON  MALARIA. 


37 

ter  in  marshes  appears  to  enhance  the  copiousness  and 
virulence  of  miasmata  to  a very  obvious  degree.” — 
M It  is  a1  singular  fact,”  says  the  Doctor.  u that  the  wa- 
ter of  the  sea  is  much  more  apt  to  enter  into  putre- 
factive decomposition  than  fresh  water  ; and  this,  no 
doubt,  depends  on  the  great  quantity  of  organic  mat- 
ter which  it  contains.” 

But  to  return  to  the  delta  of  the  Mississippi. — 
Fort  Pike  is  thirty-five  miles  Northeast  from  New 
Orleans,  and  situated  on  the  Island  of  Petites  Coquil- 
les.  This  Island,  elevated  about  two  feet  above  the 
Gulf,  enjoys  a rich  productive  soil,  composed  of  shells, 
argillaceous  and  vegetable  matter.  It  is  washed  on 
one  side  by  the  waters  of  Pearl  river,  and  intersect- 
ed with  numerous  bayous  and  marshes,  and  has  pools 
of  stagnant  water,  but  notwithstanding  these  invit- 
ing circumstances,  it  has  never  been  visited  by 
yellow  fever,  and  autumnal  fevers  even,  are  very 
scarce.* 

Fort  Wood  is  seven  miles  from  Fort  Pike,  and 
situated  on  the  south  side  of  the  channel,  Chef  Men- 
tieur,  one  of  the  connecting  Straits  between  Lake 
Ponchartrain  and  Lake  Borgne.  In  its  rear,  there  are 
some  cypress  and  fresh  water  swamps  of  limited  ex- 
tent, which  are  annually  replenished  by  rains  with 
fresh  water,  like  the  same  character  of  swamp  and 
marsh  in  the  rear  of  the  “ coasts,”  from  New  Orleans 
to  Bayous  La  Fourche  and  Plaquemine.  This  situa- 


Army  Statistical  Reports. 


38 


ADDRESS  ON  MALARIA. 


tion  is  decidedly  insalubrious,  according  to  the  same 
authority,  (A.  S.  Keports,)  which  makes  Fort  Pike 
comparatively  healthy;  and  Dr.  Drake  and  others 
endeavor  to  account  for  the  difference,  by  the  pre- 
sence of  salt  water  in  the  swamps  of  the  last  men- 
tioned place.  The  insufficiency  of  this  explanation, 
I have  already  denied  upon  competent  authority; 
but  even  if  it  were  true,  the  difficulty  would  still  re- 
remain  of  accounting  for  the  healthiness  of  the 
“ coasts,”  as  they  are  called,  or  banks  of  the  Missis- 
sippi, from  New  Orleans  to  the  outlets  of  Bayous  La 
Fourche  and  Plaquemine,  which  the  swamps  and 
marshes  about  Fort  Wood  closely  resemble,  and 
which  Dr.  Drake  assures  us  are  peculiarly  exempt 
from  autumnal  diseases. 

Dr.  Cartwright,  a gentleman  of  great  distinc- 
tion, in  an  article  in  the  Western  Journal  of  Medi- 
cine and  Surgery,  vol.  1,  is  reduced  to  the  necessity 
of  attributing  health  preserving  properties  to  the  wa- 
ter lily,  (Jussieua  Grandiflora,)  to  save  himself  from 
the  confession  that  there  is  no  truth  in  the  miasmatic 
hypothesis.  He  says : “ The  country  immediately 
north  of  the  line  bounding  the  growth  of  the  floating 
plant,  (which  is  about  the  30  deg.  north  latitude,) 
like  that  south  of  the  30  cleg.,  is  alluvial,  contains 
lakes,  swamps  and  stagnant  water,  is  covered  with 
nearly  the  same  vegetable  productions ; but  its  at- 
mosphere is  evidently  insalubrious,  its  stagnant  waters 
impure,  its  inhabitants  sickly,  and  human  life  of  short 


ADDRESS  OUT  MALARIA. 


39 


duration,  while  the  country  of  the  aquatic  plant,  im- 
mediately south  of  it,  contains  a wholesome  atmos- 
phere, pure  water,  healthy  and  long  lived  inhabitants.” 
In  some  situations,  within  the  region  of  the  floating 
plant,  where  the  Doctor  thought,  if  the  country  con- 
tained sickly  spots  anywhere,  they  richly  deserved  to 
be  so  considered,  he  found  the  inhabitants  altogether 
exempt  from  autumnal  diseases. 

In  regard  to  the  value,  however,  of  this  theory 
of  Dr.  Cartwright,  Dr.  Drake  remarks,  that  “ it  is 
at  least  an  open  question,  as  the  ‘ coasts,’  or  banks 
of  the  Mississippi,  from  New  Orleans  to  the  outlets 
of  Bayou  Plaquemine  and  Bayou  La  Fourche,  lying 
nearly  north  of  the  region  of  Jussieua  Grandiflora, 
are  equally  free  from  autumnal  diseases  and  contain 
as  many  aged  inhabitants.” 

Dr.  Carpenter,  in  an  article  in  the  New  Orleans 
Medical  and  Surgical  Journal,  “ on  periodicity  as  an 
element  of  disease,”  corroborates  this  statement  of  Dr. 
Drake,  and  says : “ On  some  of  the  Bayous  of  our 

delta,  La  Fourche  and  Terrebonne,  for  example,  the 
habitable  land  is  limited  to  narrow  stripes  of  a few 
hundred  feet  to  a mile  in  width,  which  form  the  banks 
of  the  streams,  and  follow  their  windings,  and  which 
are  surrounded,  on  all  sides,  by  swamps  and  marshes, 
in  some  places  wooded,  and  in  others,  open  and  expos- 
ed ; yet,  notwithstanding,  these  regions  are  more  ex- 
empt from  intermittents  than  almost  any  other  por- 
tion of  the  State.” 


40 


ADDRESS  ON  MALARIA. 


Here,  then,  we  have,  confessedly,  an  ample  sup- 
ply of  all  the  materials  required  by  the  miasmatists 
for  the  manufacture  of  malaria;  but,  indeed,  the 
country  seems  to  be  so  singularly  and  unexpectedly 
exempt  from  miasmatic  diseases,  that  every  one  is 
looking  out  for  some  countervailing  agency,  some 
means  of  neutralizing  the  marsh  poison,  which  each 
believes  must  be  generated  under  circumstances  so 
favorable  for  its  evolution.  Each  learned  Doctor  has 
his  own  peculiar  views  upon  the  subject,  whilst  the 
common  people  generally  say  it  is  owing  to  the  pre- 
valence of  sea  breezes ; but  why  do  not  the  sea 
breezes,  felt  with  equal  force  and  constancy  at  the 
head  of  Pensacola  bay,  where  the  Escambia  river  emp- 
ties, and  where  there  is  one  little  marsh  of  some  one 
or  two  miles  in  extent,  instead  of  a whole  region  of 
marshes,  preserve  that  locality  from  the  reputation  of 
being  one  of  the  most  insalubrious  spots  on  the  face 
of  the  earth  ?* 

So,  likewise,  in  our  own  State,  we  have  extensive 
tracts  of  swamp  land,  in  which  a great  number  of  la- 
borers are  engaged  every  year  in  getting  shingles. — 
These  laborers  not  only  work  during  the  day  in  these 
swamps,  and  drink  swamp  water,  which  is  greatly  dis- 
colored by  decaying  vegetable  matter,  but  sleep  in 
them  at  night,  in  open  huts  or  rudely  constructed 
shanties  ; yet  they  are  decidedly  the  healthiest  por- 
tion of  the  laboring  classes  in  those  parts  of  the  State. 


*Lind  and  others. 


ADDRESS  ON  MALARIA. 


41 


Now,  this  cannot  be  owing,  as  some  pretend  to  believe, 
to  the  fact,  that  as  the  swamps  are  not  entirely  clear- 
ed and  drained,  vegetable  decomposition  does  not 
take  place,  because  that  is  palpably  an  error.  Our 
own  senses  teach  us  such  is  not  the  case,  and  that  ve- 
getable decomposition  does  take  place  to  an  enormous 
extent.  The  whole  superstratum,  which  is  oftentimes 
many  feet  in  thickness,  consists  of  the  debris  of  vege- 
table and  animal  matter ; for  these  swamps  are  scarce- 
ly more  noted  for  their  luxuriant  vegetation,  than 
they  are  for  them  abundance  of  insects  and  reptiles. 
Besides,  I am  informed  by  Mr.  Redding  L.  Myers,  a 
respectable  gentleman  of  the  town  of  Washington, 
who,  as  assistant  engineer,  had  charge,  in  part,  of  the 
workmen  employed  upon  the  public  lands  about  Pun- 
go  Lake,  that  they  were  remarkably  healthy.  Here, 
an  extensive  and  systematic  plan  of  drainage,  by  ca- 
naling  and  ditching,  exposed  the  laborers  to  the  ex- 
halations from  the  soil,  under  a variety  of  circumstan- 
ces, as  well  upon  the  prairie  marshes,  as  in  the  open 
swamps  and  close  jungles;  and  yet  they  scarcely  had 
any  fever  amongst  them,  or  required  the  attention  of 
a physician,  during  the  two  or  three  years  they  were 
engaged  in  this  service. 

The  Antilles,  Brazil,  East  Indies,  Europe  and 
other  parts  of  the  earth,  furnish  us  examples  of  the 
same  kind.  British  Guiana,  with  its  wet  and  dry  sea- 
sons, and  extensive  alluvial  marshes,  which  have  been 
reclaimed  from  the  sea  by  a most  expensive  and  per- 


42 


ADDRESS  ON  MALARIA. 


manent  system  of  diking,  together  with  its  culture 
of  Sugar,  Rice,  Indigo,  <fcc.,  is  represented  by  a writer 
in  the  British  and  Foreign  Medico-Chirurgical  Review 
for  1850,  as  “among  the  most  healthy  of  the  West 
Indian  Colonies,  and  capable  of  being  healthfully  te- 
nanted by  European  residents,”  notwithstanding  “ its 
wide  alluvial  tracts.” 

Ferguson  says : “ The  town  of  New  Amsterdam, 
Berbice,  is  situated  within  short  musket  shot  to  lee- 
ward of  a most  offensive  swamp,  in  the  direct  tract 
of  a strong  trade  wind  that  blows  night  and  day,  and 
frequently  pollutes  even  the  sleeping  apartments  of 
the  inhabitants,  with  the  stench  of  the  swamps  ; yet 
it  had  produced  no  endemic  fever  worthy  of  notice, 
even  among  the  newly  arrived,  for  a period  of  years 
previously  to  my  visiting  that  colony.” 

“The  town  of  Kingston,  in  the  island  of  St. 
Vincent,  is  so  situated,”  says  Robert  Armstrong,  “as 
to  have  all  the  elements  necessary  for  the  production 
of  this  vegeto-animal  poison,  heat,  moisture,  decayed 
and  decaying  vegetable  matter,  with  as  large  a pro- 
portion of  reptiles,  insects  and  other  animal  matter 
as  is  found  in  other  tropical  countries ; yet,  strange  to 
say,  the  town  of  Kingston  is  one  of  the  most  healthy 
spots  in  the  West  Indies.  I was  informed  by  the 
staff  surgeon  to  the  forces,  who  had  long  resided 
there,  that  it  ivas  as  healthy  as  the  most  favorable  spot 
in  England.'1'1 

Brazil,  too,  is  said  to  be  entirely  exempt  from 


ADDRESS  Oil  MALARIA. 


43 


endemics,  although,  it  has  an  extremely  fertile  soil,  a 
sultry  atmosphere,  and  a most  magnificent  profusion 
of  vegetation  of  almost  endless  variety.  This  vast 
empire  is  intersected  every  where  with  navigable 
streams,  which  pour  their  waters  through  a common 
mouth  into  the  Ocean,  and  indented  along  its  sea 
coast,  of  more  than  two  thousand  miles  in  extent, 
with  numerous  beautiful  and  safe  harbors.  The  Del- 
ta of  the  Amazon  alone  spreads  along  the  Atlantic 
shore,  on  either  side  of  the  equator,  to  the  breadth  of 
one  hundred  and  fifty  miles,  and  its  length  from  the 
ocean  to  the  farthest  point  where  the  ebbing  and 
flowing  of  the  regular  tides  are  felt,  and  where  the 
innumerable  islands  and  labyrinth  of  channels  begin, 
is  over  six  hundred  miles.  The  intelligent  Ameri- 
can travellers,  Kidder  and  Edwards,  spent  several 
years  in  this  country,  and  concur  in  representing 
every  portion  of  it,  even  the  entire  valley  of  the 
Amazon,  embracing  nearly  one-half  of  this  vast  ter- 
ritory, as  salubrious  in  a remarkable  degree.  The 
latter,  Edwards,  says  he  never  saw  but  one  case  of 
Intermittent  during  the  three  years  he  remained  in 
the  country,  and  that  he  cured  with  a single  dose  of 
medicine. 

Dr.  Horner,  of  the  United  States  Navy,  in  des- 
cribing the  topography  of  the  city  of  Kio  Janeiro, 
says : “ The  proximity  of  the  Ocean,  the  great  size  of 
the  harbor,  the  great  height  of  the  land  about  it, 
many  hills,  narrow  streets,  and  high  temperature, 


44 


ADDRESS  ON  MALARIA. 


keep  Rio  almost  without  cessation  immersed  in  a 
heavy,  sultry  atmosphere,  rendered  more  disagreea- 
ble by  want  of  cleanliness  and  the  exhalations  from 
the  ravines  and  marshy  grounds  in  its  rear,” — yet 
Rio,  notwithstanding,  is  considered  by  travellers  ge- 
nerally, who  have  spent  some  time  there,  as  well  as 
in  other  parts  of  Brazil,  to  be  healthy.  And  W alsh 
informs  us  that  for  many  weeks  at  a time,  during  the 
rainy  season,  there  were  several  hours  in  each  day 
when  his  clothes  would  be  wet  on  him,  and  that  he 
oftentimes  put  on  wet  clothes  in  the  morning,  which 
had  remained  wet  all  night ; and  that  whenever  the 
sun  shone  out,  it  was  so  intensely  hot,  that  he  went 
smoking  along  in  his  wet  clothes,  the  water  from 
which  was  exhaling  by  heat  and  dissolving  into  va- 
por. “ Such  weather,”  to  use  his  own  language,  “ in 
Africa,  under  the  same  latitude,  no  human  being  could 
bear;  but  not  so  in  Brazil;  no  one  is  affected  by 
those  states  of  the  atmosphere  which  are  so  fatal  else- 
where. It  has,  with  some  reason,  therefore,  grown 
into  a proverb,  that  it  is  a country  where  a physician 
cannot  live,  and  yet  where  he  never  dies.” 

Dr.  Dundas,  in  his  sketches  of  Brazil,  after  giv- 
ing a full  description  of  the  medical  topography  and 
condition  of  Bahia,  showing  conclusively  that  in  that 
city  are  accumulated,  in  almost  unexampled  abund- 
ance, all  the  physical  conditions  which  are  considered 
by  the  miasmatists  to  constitute  the  elements  essential 
for  the  production  of  febrilic  miasms,  says : “Yet, 


ADDEESS  ON  MALARIA. 


45 


notwithstanding  this  appalling  combination  of  physi- 
cal, moral  and  social  evils,  universally  admitted  as 
the  chief  agents  in  producing  the  most  extensive  and 
fatal  diseases,  Bahia  continued,  and  can,  moreover, 
up  to  the  present  hour,  boast  the  happy  privilege  of 
having  escaped,  since  the  period  of  its  foundation, 
from  every  species  of  endemic  or  epidemic  malady — 
yellow  fever,  cholera , influenza , typhus  and  dysentery 
He  also  states  that  the  town  of  Bomfim,  situated  in 
the  midst  of  a morass,  and  supplied  with  an  immense 
quantity  of  vegetable  and  animal  matters,  exuviae- , 
insects,  &c.,  which  are  constantly  acted  on  by  the 
powerful  influence  of  a tropical  sun,  yet  enjoys  the 
reputation  of  being  one  of  the  healthiest  districts  in 
Brazil.  And  he  further  states  that  the  inhabitants 
of  Bomfim  sometimes  have  intermittents  during  the 
winter  season,  when  the  marshes  are  completely  flood- 
ed, and  therefore  cannot  furnish  febrific  exhalations, 
and  when  a strong  S.  S.  E.  wind,  which  blows  direct- 
ly from  the  ocean,  sweeps  over  the  town ; but  they 
never  have  them  in  the  hot  dry  months  of  summer, 
when  the  place  is  reeking  with  the  effluvia  of  the 
marshes.  These  circumstances  induce  him  to  believe 
that  marsh  poison  has  no  agency  in  producing 
these  periodic  fevers,  but  that  they  are  most  pro- 
bably attributable  to  exposure  to  moist  sea  breezes. 

This  opinion  of  Dr.  Dundas  derives  some  sup- 
port from  the  fact  that  a North  East  wind  in  Batavia, 
which,  from  the  geographical  position  of  the  place, 


46 


ADDRESS  ON  MALARIA. 


being  on  the  north  side  of  the  island,  must  blow  from 
the  sea,  and  not  over  moist  or  malarious  ground,  is 
highly  injurious  to  health. 

Other  places  are  likewise  known  to  be  rendered 
insalubrious  by  the  moist,  cold  winds  of  the  ocean, 
that  sweep  directly  over  them,  without  impinging 
upon  malarious  soil,  as  Tobago,  and  Grenada,  and 
Edenburgh,  for  example,  where  the  east  wind  is  a 
very  unhealthy  one.  But  this,  according  to  the  “ro- 
bust faitlH''  of  some  of  the  miasmatists,  Horsefield, 
La  Roche  and  others,  is  due  to  the  agency  of  mias- 
mata which  have  been  blown  across  the  ocean  from 
the  fens  of  Holland ! ! 

New  South  Wales,  including  South  Australia, 
and  Australia  Felix,  has  a wet  and  dry  season,  an 
abundance  of  streams,  bays,  estuaries,  swamps  and 
ponds  of  stagnant  water,  and  in  some  places,  particu- 
larly about  its  town,  a rich  and  highly  productive 
soil.  It  is  likewise  subject  to  inundations  from  the 
rivers,  and  its  alluvial  swamps  to  overflow  from  the 
sea,  yet,  notwithstanding  all  these  indications  of  a 
sickly  climate,  New  South  Wales  is  exceedingly  heal- 
thy and  free  from  endemics.* 

“ The  island  of  Java,”  says  Sir  Stamford  Raf- 
fles, one  of  the  Lieutenant-Governors  of  that  island 
and  its  dependencies,  “ stands  on  a level,  in  point  of 
salubrity,  with  the  very  healthiest  parts  of  British 
India,  or  any  tropical  country  in  the  world,  although 


* Malte  Bran  and  Byrne. 


ADDRESS  ON  MALARIA. 


47 


it  abounds  in  a most  luxuriant  vegetation,  and  in 
numberless  streams,  cataracts  and  rivulets,  which  are 
tamed  to  the  peasant’s  will.  In  the  hottest  and  driest 
season,  they  are  made  to  retain  some  of  their  water 
which  the  farmer  directs  into  endless  conduits  and 
canals  to  irrigate  the  lands,  which  he  has  laid  in  ter- 
races for  its  reception.  It  thence  descends  to  the 
plains  and  spreads  aver  them , shedding  fertility  where- 
ever  it  flows,  till  at  last,  by  innumerable  outlets,  it 
discharges  itself  into  the  sea.” 

This  same  system  of  artificial  irrigation,  which 
is  so  innocuous  in  Java,  is  believed  by  Dr.  Wilson, 
in  his  medical  notes  on  China,  to  be  the  cause  of  the 
unhealthiness  of  the  Islands  of  Chusan  and  Hong 
Kong  : for,  in  discussing  this  question,  he  says:  “The 
meteoric  influences  and  the  aspect  of  the  country  ap- 
pear highly  favorable  to  health — what  is  detrimental 
is  believed  to  be  chiefly  the  wilful  work  of  man’s 
hands,  or  of  perverse  ignorance.” 

Dr.  Thomas,  in  his  remarks  “ on  the  peculiarities 
in  figure,  the  disfigurations,  and  the  customs  of  the 
New  Zealanders,  and  on  their  diseases,  and  their 
modes  of  treatment,”  says:  “I  have  not  seen  a case 
of  Intermittent  or  Remittent  fever  among  the  New 
Zealanders,  and  Dr.  Rees,  who  has  been  resident  for 
ten  years  near  a populous  pa  (village)  on  the  bank 
of  the  Wanganui  river,  has  never  seen  one  either.” 

“ It  is  very  remarkable,”  says  Dr.  Thomas,  “ that 
in  New  Zealand,  where  the  temperature  is  for  many 


48 


ADDRESS  ON  MALARIA. 


months  about  60  deg.  Fahr.,  where  the  uncultivated 
land  is  covered  with  thick  wood  and  fern,  up  to  the 
very  door  of  a New  Zealander’s  hut — where  the  mois- 
ture of  the  climate  is  great — that  diseases  which  are 
attributed  to  marsh  poison  are  almost  unknown. — 
Even  Europeans  who  have  lived  for  years  on  the  al- 
luvial soil  on  the  banks  of  the  Waipa  and  Waikato 
rivers,  and  in  the  low  town  of  Kororarika,  have 
scarcely  ever  contracted  ague ; and  Europeans  who 
have  suffered  from  ague  in  tropical  and  other  coun- 
tries, have  recovered  from  the  malady  after  a few 
years  residence  in  New  Zealand.” 

Mr.  Peale,  the  Geologist  to  the  exploring  expedi- 
tion under  Captain  Wilkes,  in  a letter  to  Dr.  Dun- 
glison,  published  in  the  Medical  Examiner  for  1843, 
states,  that  they  visited  situations  in  the  course  of 
their  travels  amongst  the  Friendly,  Society,  Fegee, 
Samoan  and  Sandwich  Islands,  where  the  inhabitants 
subsisted,  in  part,  upon  the  root  of  the  Tarro  plant, 
which  requires  to  be  cultivated,  like  our  rice,  in  shal- 
low fresh  water  ponds  and  marshes,  and  where  natu- 
ral marshes  do  not  occur,  they  are  artificially  con- 
structed by  the  natives.  He  states  further,  that  they 
often  found  their  towns  situated  in  the  midst  of  these 
“ Tarro  patches,”  which  plentifully  supplied  the  resi- 
dences with  musquitoes  and  other  insects,  and  the 
stench  of  the  marshes  ; yet  neither  the  officers,  nor 
men,  nor  the  scientific  corps,  suffered  in  consequence 
of  their  exposure,  although  they  were  in  the  midst 


ADDRESS  OK  MALARIA. 


49 


of  the  exhalations  from  these  marshes  day  and  night, 
living  and  sleeping,  owing  to  “ the  shore  duties  of 
the  service,  in  the  midst  of  marsh  stenches  and  mus- 
quitoes,  when  the  days  were  hot,  and  the  huts  open 
and  exposed.” 

Captain  Wilks  mentions  that  these  Islands  are 
hot,  moist,  fertile,  and  remarkably  healthy. 

On  the  other  hand,  Mr.  Peale  observes  that  al- 
most every  one  of  the  expedition  suffered  more  or 
less  from  endemic  diseases,  after  their  arrival  on  our 
northwest  coast,  that  were  encamped  upon  the  Wal- 
lamette  river,  in  Oregon,  where  there  were  no  marshy 
grounds,  excessive  moisture,  stagnant  ponds,  or  other 
sources  of  miasm,  as  both  the  earth  and  the  atmos- 
phere were  remarkably  dry. 

Dr.  Hope,  of  Princeton,  in  a letter  to  Prof.  J.  K. 
Mitchell,  of  Philadelphia,  describes  the  Island  of 
Singapore,  which  lies  within  the  tropics,  and  abounds 
in  streams,  marshes,  ponds  and  pools  of  stagnant  wa- 
ter, with  its  jungles  and  a most  luxuriant  vegetation 
in  many  places,  of  astonishingly  rapid  growth,  and 
equally  rapid  decay,  as  being  very  rarely  visited  by 
fevers  of  any  kind,  and  when  they  did  occur,  were 
from  “ imprudent  exposure  to  fatigue  or  the  sun.” — 
“ Singapore”  says  the  Doctor,  “ is  considered  a kind 
of  Sanatarium  for  the  oriental  invalids,  who  go 
thither,  from  every  quarter  of  the  eastern  world, 
to  escape  from  malaria  or  to  recover  from  chronic  dis- 
eases.” 


4 


50 


ADDRESS  ON  MALARIA. 


The  Island  of  Mauritius,  in  the  eastern  hemis- 
phere, all  writers  concur  in  representing  as  strikingly 
like  Jamaica,  “ so  far  as  regards  temperature,  rain, 
physical  aspects,  and  diversity  of  climate.”  It  is  in 
the  same  latitude  also,  with  the  exception  of  being 
south  of  the  line,  yet  it  is  perfectly  healthy,  and,  as 
Major  Tullock  informs  us,  “ so  far  as  can  be  ascer- 
tained from  the  statistical  returns  of  the  island,  the 
climate  does  not  exert  any  prejudicial  influence  on 
the  health  of  the  resident  white  population,”  whilst 
Jamaica  is  a notoriously  sickly  place. 

It  is  likewise  a well  ascertained  fact,  that  the  ex- 
tensive marshy  grounds  on  the  South  West  coast  of 
Ceylon,  between  ISTegombo  and  Galle,  do  not  render 
that  district  of  country  insalubrious ; while  it  is  equal- 
ly certain  that  many  of  its  mountain  ranges  on  the 
opposite  coast  are  remarkably  sickly. 

In  Ireland,  emphatically  a country  of  swamps, 
bogs  and  ponds,  the  inhabitants  in  the  linen  manufac- 
turing districts  rot  their  flax  in  dead  water  ponds 
and  ditches,  thus  filling  the  whole  atmosphere  with 
the  effluvia  from  this  mass  of  decomposing  vegeta- 
ble matter ; yet,  Ireland,  even^  under  such  favora- 
ble circumstances  for  the  production  of  miasmata,  is 
not  subject  to  endemics  of  intermittent  and  remittent 
fevers. 

Dr.  Bell,  in  an  article  “ On  miasm  as  an  alleged 
cause  of  fevers,”  in  the  11th  vol.  of  the  Philadelphia 
Medical  Journal,  says:  “The  inhabitants  of  every 


ADDRESS  ON  MALARIA, 


51 


Dutch  House  ought,  from  the  above  creed,  to  be  at- 
tacked annually  with  intermittent  fevers,  since  to 
each  is  attached  a summer  house,  situated  immedi- 
ately over  a small  stagnant  canal,  covered  with  ve- 
getable remains,  and  exposed  to  the  sun’s  rays. — 
Here,  hours,  especially  in  the  evening,  are  spent  by 
the  family,  without  the  members  of  it  being  afflicted 
with  disease.” 

So,  what  is  called  the  “Jew's  Quarter ,”  in  Rome, 
is  represented  by  Dr.  James  Johnson,  in  his  work  on 
change  of  air,  as  the  dirtiest,  filthiest,  dampest,  “ and 
the  healthiest  spot  in  that  famous  city?  Being  down 
upon  the  shores  of  the  Tiber,  and  more  exposed  to  the 
vapors  from  the  river,  and  wet  river  banks,  than  any 
other  portion  of  the  Roman  Capital,  it  ought  to  be 
sickly,  according  to  the  views  of  the  miasmatists,  but 
u it  is  quite  free  from  the  fatal  malaria,” 

And  Lisbon,  one  of  the  filthiest  towns  in  all  Eu- 
rope, cannot  carry  on  gardening,  which,  in  so  dry  a 
country,  is  of  the  utmost  importance  to  every  family, 
without  artificial  irrigation,  and  that  the  inhabitants 
may  be  able  to  accomplish  this  desirable  purpose, 
the  water  is  collected  during  the  rainy  season  in  the 
cisterns  in  their  gardens,  and  under  their  houses. — 
“ The  water,”  says  Ferguson,  “being  of  utmost  impor- 
tance, is  husbanded  carefully,  for  several  months  in 
the  dry  season.  Diminishing  daily  by  drainage  and 
evaporation,  it,  of  course,  gets  into  a most  concentra- 
ted state  of  foulness  and  putridity,  with  a thick  green 


52 


ADDRESS  ON  MALARIA. 


vegetable  scum  upon  it ; yet  no  one  ever  dreamed  of 
its  producing  fever,  although  the  most  ignorant  na- 
tive is  well  aware,  that  were  he  to  cross  the  river,  and 
sleep  on  the  shores  of  the  Alentejo,  where  a particle 
of  water,  at  that  season,  had  not  been  seen  for  months, 
and  where  water,  being  absorbed  into  the  sand  as 
soon  as  it  fell,  was  never  known  to  be  putrid,  he 
would  run  the  greatest  risk  of  being  seized  with  re- 
mittent fever.”*  The  same  author  gives  us  another 
example  of  a somewhat  similar  nature.”  “In  the 
West  India  Sugar  Ships,”  he  observes,  “ the  drainage 
of  the  Sugar,  mixed  with  the  bilge  water  of  the 
hold,  creates  a stench  that  is  absolutely  suffocating  to 
those  unaccustomed  to  it,  yet  it  is  denied  that  mala- 
ria or  malarious  diseases  are  generated  even  from 
this  combination.” 

Drs.  John  Wilson  and  Bryson,  also  bear  testimo- 
ny to  the  fact,  that  the  foulest  and  most  offensive 
ships  oftentimes  prove  innocuous  ; while  disease  has 
been  known  to  rage  aboard  vessels  where  there  was 
nothing  offensive  or  foul. 

So,  the  water  of  the  Thames,  according  to  Dr. 
Dunglison,  loaded  with  all  the  filth  and  soluble  ma- 
terials, animal  and  vegetable,  which  it  acquires  in  its 
course  to  the  sea,  is  nevertheless  the  best  water  to  take 
on  a long  voyage ; for  having  undergone  a process  of 
fermentation,  or  self  purification,  it  keeps  sweet  and 
potable  a great  while.  Accordingly,  merchantmen 


* Article  on  Marsh  Poison,  Ac- 


ADDRESS  ON  MALARIA. 


53 


and  ships  of  war  fill  with  it  their  water  tanks,  which 
are  situated  immediately  under  the  hammocks  and 
berths  of  the  men.  Now,  during  the  fermentation  of 
the  water,  which  takes  place  after  a little  while,  the 
sleeping  apartments,  and,  indeed,  all  portions  of  the 
ship,  are  tilled  with  an  intolerable  stench ; yet  it  ne- 
ver produces  disease. 

I shall  now  call  your  attention  to  another  class 
of  facts.  In  Guinea,  according  to  Lind,  and  other 
writers,  during  the  entire  period  of  continued  heat 
and  drought,  which  sometimes  lasts  for  six  or  eight 
months,  when  everything  is  parched  up,  and  the  earth 
is  literally  baked  and  cracked  open  in  great  fissures, 
and  the  rivers  dried  up,  or  restricted  to  very  narrow 
channels,  leaving  a large  portion  of  their  alluvial  beds 
and  slimy  mud  banks  exposed  to  the  rays  of  the  burn- 
ing sun,  there  is  no  disease.  But  when  the  rains  have 
set  in,  and  the  parched  earth  is  soaked  with  water, 
and  the  rivers  begin  to  fill  up,  diseases  become  rife 
and  the  mortality  is  great. 

Egypt,  too,  which  is  inundated  or  partially  co- 
vered by  the  overflowing  waters  of  the  Nile  for  near- 
ly three-fourths  of  the  year,  and  which  has  its  atmos- 
phere filled  with  the  exhalations  from  stagnant  lakes, 
canals  and  pools,  and  the  drying  up  of  its  deep  allu- 
vial soil  by  the  action  of  a powerful  sun,  producing 
an  excessive  evaporation,  enjoys  freedom  from  ende- 
mics of  intermittent  and  remittent  diseases  ; and,  in- 
deed, since  the  days  of  the  celebrated  Yolney,  travel- 


54 


ADDEESS  ON  S1ALAEIA. 


lers  generally  have  agreed  that  its  climate  was  salu- 
brious— much  more  so  than  Cypress  and  other  parts 
of  the  Levant,  less  abundantly  furnished  with  the 
supposed  sources  of  miasm.  Let  us  take  a single  ex- 
ample of  this  fact.  Menouf,  the  capital  of  one  of  the 
provinces  of  lower  Egypt,  although  its  south  and 
west  walls  are  situated  on  the  banks  of  a very  shal- 
low canal,  and  near  to  another  still  shallower,  neither 
being  navigable,  and  the  latter  consisting  chiefly  of 
stagnant  pools,  is,  notwithstanding,  a remarkably 
healthy  place.  Besides  these  canals,  there  are,  in  the 
immediate  neighborhood  of  the  town,  ponds  of  dead 
water,  in  which  the  inhabitants  rot  their  flax,  with 
here  and  there  a burying  ground,  which  is  overflowed 
by  the  high  waters  from  the  Nile ; but  as  the  waters 
do  not  remain  on  the  lands  about  Menouf  as  long  as 
they  do  over  most  other  parts  of  the  Delta,  Surgeon 
Carrie  thinks  this  may  be  the  reason  of  its  extreme 
healthiness. 

So,  in  our  own  State,  on  the  lower  Boanoke, 
where  the  bottom  lands  are  guarded  from  the  river 
inundations  by  diking,  in  August  last,  owing  to  a very 
unusual  rise  in  the  river,  the  levees  gave  way  in  many 
places,  and  large  farms  and  extensive  tracts  of  land, 
heretofore  protected  against  such  inundations,  were 
overflowed.  When  this  disastrous  rise  in  the  river  oc- 
curred, the  farms  were  covered  with  luxuriant  grow- 
ing crops,  and  an  abundance  of  vegetable  matter,  in 
a succulent  state,  occupied  the  bottom  lands  and  mar- 


ADDRESS  ON  MALARIA. 


55 


shes.  In  many  places,  all  this  mass  of  vegetable  mat- 
ter was  destroyed  entirely,  and  left,  by  the  subsidence 
of  the  flood,  to  putrify  upon  the  land,  filling  the 
whole  ah  with  its  stench,  whilst  the  earth’s  surface, 
by  excessive  evaporation,  during  an  unusually  warm 
and  long  autumn,  became  perfectly  dry  and  even 
baked,  cracking  open  in  many  places  with  long  and 
deep  fissures.  Such  was  particularly  the  case  with 
regard  to  the  bottom  lands  and  marshes  in  the 
counties  of  Northampton,  Halifax  and  Bertie ; and 
yet,  I am  informed  by  gentlemen  of  high  intelligence 
and 'standing,  part  owners  of  these  lands,  that,  con- 
trary to  all  expectation,  it  was  an  unusually  healthy 
season. 

Such  a state  of  dryness,  I must  admit,  perhaps, 
according  to  Bancroft,  ought  not  to  have  evolved  mi- 
asm ; but  it  is  precisely  under  such  a condition  of  the 
atmosphere  and  earth’s  surface,  that  diseases  are  often 
violent,  and  the  mortality  greatest,  agreeably  to 
Brown,  Pringle,  Fordyce,  Ferguson  and  others  ; and 
I now  propose  to  examine  the  subject  in  that  point  of 
view.  The  last  named  writer,  a standard  authority, 
insists,  “ that  putrefaction  and  the  matter  of  disease 
are  altogether  distinct  and  independent ; that  the  one 
travels  beyond  the  other  without  producing  the  small- 
est bad  effects  ; and  that,  however  frequently  they 
may  be  found  in  company,  they  have  no  necessary 
connection ; and  that  the  cause  of  disease  “ cannot 
emanate  from  vegetable  putrefaction,  but  is  found 


56 


ADDRESS  ON  MALARIA. 


most  virulent  and  abundant  on  tlie  driest  surfaces ; 
often,  where  vegetation  never  existed  nor  could  ex- 
ist,” &c * 

Dr.  Watson,  speaking  of  these  views  of  Fergu- 
son, appears  to  agree  with  him  in  this  opinion,  for  he 
says:  “Facts  like  these  seem  to  prove  that  the  mala- 
ria, and  the  product  of  vegetable  decomposition,  are 
two  distinct  things.  They  are  often  in  company  with 
each  other,  but  they  have  no  necessary  connection. — 
Whoever,  in  a malarious  country,  waits  for  the  evi- 
dence of  putrefaction,  will  wait,  says  Dr.  Ferguson, 
too  long.” 

Ferguson  also  says  : “ A year  of  stunted  vegeta- 
tion, through  dry  seasons  and  uncommon  drought,  is 
infallibly  a year  of  pestilence  to  the  greater  part  of 
the  West  India  Islands;”  and  that  “the  most  ignor- 
ant peasant  of  Lincolnshire  knows  that  there  is  noth- 
ing to  be  apprehended  from  the  ditches  of  his  farm, 
till  they  have  been  dried  up  by  the  summer  heat." — 
Much  autumnal  disease  was  likewise  observed  by  him 
in  South  Holland,  in  1194,  after  a hot  dry  summer, 
at  the  encampments  of  the  British  Forces,  at  Rosen- 
daal  and  Oosterhout,  where  the  surface  was  a level 
plain  of  dry  sand,  without  vegetation,  and  where  no 
vegetation  conld  exist,  except  the  stunted  heath  plant, 
and  where  all  the  wells  of  the  camps  were  plentiful- 
ly supplied  with  sweet  and  potable  water. 

Prinole  also  bears  testimonv  to  the  insalubrity 

O *J  v 


* Article  on  Marsh  Poison,  &c. 


ADDRESS  ON  MALARIA. 


57 


of  the  dry,  unproductive  sandy  plains  of  Dutch.  Bra«- 
bant,  whilst  Fordyce  informs  us  that  the  British  Ar- 
mies, -when  encamped  upon  the  pure  sandy  plains  of 
Flanders  in  1810  and  1811,  were  greatly  troubled 
with  intermittents  and  remittents  ; and  also,  that 
there  is  a region  in  Peru,  barren  from  want  of  water 
and  vegetation,  and  yet  nearly  uninhabitable  from 
the  prevalence  of  virulent  fevers.  Similar  observa- 
tions have  been  made  by  almost  every  one  who  has 
attentively  noticed  these  things.  Mr.  Charles  Dar- 
win, for  example,  in  his  voyage  of  a naturalist,  in 
speaking  of  the  elevated,  dry  and  almost  arid  coasts 
of  Peru,  says : “ In  all  seasons,  both  inhabitants  and 
foreigners,  suffer  from  severe  attacks  of  ague.  The 
attacks  of  illness,  which  arise  from  miasma,  never  fail 
to  appear  most  mysterious — so  difficult  is  it  to  judge 
from  the  aspect  of  a country,  whether  or  not  it  is 
healthy,  that  if  a person  had  been  told  to  choose 
within  the  tropics  a situation  appearing  favorable  to 
health,  very  probably  he  would  have  named  this 
coast.” 

The  result  of  Ferguson’s  observations  on  the  me- 
dical topography  of  Spain,  is,  “ that,  in  the  most  un- 
healthy parts  of  Spain,  we  may,  in  vain,  towards  the 
close  of  summer,  look  for  lakes,  marshes,  ditches, 
pools,  or  even  vegetation ; and  that  Spain,  generally 
speaking,  though  as  prolific  of  endemic  fevers  as  Wal- 
cheren,  is,  beyond  all  doubt,  one  of  the  driest  coun- 
tries in  Europe,  and  it  is  not  till  it  has  again  beer 


58 


ADDRESS  ON  MALARIA. 


made  one  of  the  wettest,  by  the  periodical  rains,  with 
its  vegetation  and  aquatic  weeds  restored,  that  it  can 
be  called  healthy,  or  even  habitable,  with  any  degree 
of  safety.” 

Dr.  Brown,  a decided  miasmatist,  confirms  this 
statement,  and  adds : “ He  has  repeatedly  observed 
that  cases  of  fever  and  ague  abounded  in  parts  of  Es* 
tremadura,  so  remote  from  the  Gaudiana  or  any 
stream,  that  no  influence  from  visible  water  or  damp- 
ness could  be  supposed  to  have  a share  in  then  pro- 
duction.”'" 

And  Professor  Merrill,  a man  of  deserved  consi- 
deration, in  a lecture  before  the  Memphis  Medical  So* 
ciety,  adverting  to  the  great  mass  of  irrefragable  evi- 
dence adduced  by  Ferguson  and  others  against  the 
“ decomposition  theory ;”  and  in  Hew  of  the  “ many 
well  authenticated  instances  of  the  prevalence  of  the 
most  malignant  and  deadly  forms  of  fever,  in  the 
midst  of  hot  and  parched  up  sand  plains,  where  there 
was  nothing  to  decay,  or  moisture  enough  to  admit  of 
decomposition  even  if  there  were  materials  for  it," 
says  : “ Modern  writers  cannot  refuse  then’  testimony 
against  the  decomposition  theory,  unless  they  are 
willing  to  discredit  the  statements  to  which  I have 
referred,  which  no  man  living  has  had  the  hardihood 
to  do,  for  they  are  sustained,  among  other  witnesses, 
by  the  whole  of  those  vast  armies,  officers  and  men, 
which  the  British  government  to  the  astonishment  of 


Cyclopedia  of  Practical  Medicine. 


ADDEESS  ON  MALAEIA. 


59 


the  world,  kept  in  the  field  for  a series  of  years,  bat- 
tling against  Napoleon.  It  is  remarkable,  that  not- 
withstanding the  statements  of  Ferguson  and  others, 
were  in  direct  opposition  to  a doctrine  which  had 
been  universally  taught  and  credited  for  more  than  a 
century,  no  man  was  found  to  gainsay  the  evidence 
upon  which  they  were  founded.” 

“Some  two  years  ago,”  continues  Dr.  Merrill, 
“ I presented  before  this  society,  a short  account  of  an 
epidemic  yellow  fever,  which  occurred  at  the  Bay  of 
St.  Louis  in  1820.  Here  was  also  a sandy  and  barren 
country,  which  had  been  all  the  spring  flooded  by  ex- 
cessive rains.  These  were  followed  by  an  unprece- 
dented drought,  so  that  when  the  disease  appeared 
there  were,  as  in  Holland,  Spain  and  Portugal,  neith- 
er moisture  to  produce  decay,  nor  substance  upon 
which  it  could  act  had  it  existed.  A large  number 
of  the  most  intelligent  people  in  our  country  had  con- 
gregated in  that  place  to  spend  the  summer  ; and  no 
one  there  doubted,  any  more  than  here,  that  these 
diseases  were  caused  by  the  dissolution  of  organic 
matter,  nor  had  any  one  there,  perhaps,  ever  before 
seen  any  form  of  these  diseases  prevail,  where  there 
was  none  of  these  materials  to  decay.  It  was  natu- 
ral, therefore,  that  they  should  be  especially  vigilant 
to  discover  the  existence  of  this  necessary  cause,  with 
a view  to  its  removal ; and  I can  bear  witness  that 
great  activity  was  exercised  in  this  respect.  I myself 
had  no  more  doubt  of  the  truth  of  the  commonly  re- 


60 


ADDRESS  ON  MALARIA. 


ceived  doctrine  of  causation  than  I had  of  the  propa- 
gation of  small  pox  by  contagion.  And  yet  after  the 
most  diligent  search  and  enquiry,  not  a vestige  of 
any  organic  material  was  discovered,  to  afford  the 
least  ground  of  suspicion  of  injurious  influences  from 
this  cause.” 

Bishop  Heber,  in  his  account  of  India,  according 
to  Mitchell,  says,  the  wood  tracts  of  Nepaul  and  Mal- 
wa,  having  neither  swamps  nor  perceptible  moisture, 
in  summer  and  autumn  are  abandoned,  not  only  by 
man,  but  even  by  the  birds  and  beasts,  in  consequence 
of  their  pestilential  character. 

In  regard  to  the  insalubrity  of  woodlands,  mar- 
chetti,  before  quoted,  observes  that,  “The  presence 
of  crowded  and  extended  woods,  according  to  some, 
and  on  the  contrary,  their  destruction,  according  to 
others,  cause  malaria.  Targioni,  on  the  authority  of 
Doni  and  others,  considered  woods  injurious,  not  only 
for  being  liable  to  retain  and  imprison  the  principle 
constituting  malaria,  but  also  from  being,  as  he  be- 
lieved, capable  of  producing  them.  Such  a disparity 
of  opinion  proves,  in  my  judgment,  that  there  are 
circumstances  in  which  a too  extensive  and  general 
clearing  of  woods  may  be  equally  injurious,  as  allow- 
ing trees  and  shrubs  to  increase  and  multiply  with- 
out the  regulation  of  man.  We  find  certain  districts 
and  houses  with  a perfectly  healthy  atmosphere,  in  the 
midst  of  extended  woods,  while  others  in  similar  si- 
tuations suffer  from  malaria.” 


ADDRESS  ON  MALARIA. 


61 


Malta  is  a barren  rocky  Island,  considerably  ele- 
vated above  the  sea,  in  some  places  as  muck  as  twelve 
hundred  feet.  Its  substratum  consists  of  calcarious 
sandstone,  scantily  covered  with  soil,  most  of  which 
has  been  carried  thither.  It  has  no  marshes,  stagnant 
pools,  swampy  grounds,  lakes  or  rivers,  yet  Major 
Tullock  asserts  that  it  is  quite  sickly.  The  same  is 
true  of  the  town  of  Gibraltar,  which  is  built  on  a bed 
of  dry  red  sand,  at  the  foot  of  the  rock  of  that  name, 
and  has  no  ponds  or  marshes  to  furnish  decomposing 
vegetable  matter  to  generate  disease.  So,  too,  with 
one  of  the  Isles  de  Loss,  near  Sierra  Leone,  about  a 
mile  in  diameter,  and  at  its  centre  as  much  as  three 
hundred  feet  above  the  level  of  the  sea.  It  has 
no  marsh,  no  swamp,  very  little  soil,  and  only  one 
small  piece  of  arable  land,  but  it  is  represented  by 
Boyle  as  one  of  the  most  insalubrious  spots  on  the 
African  coast. 

Here  I might  be  satisfied  to  rest  the  discussion 
of  this  question,  having  already  subjected  it  to  the 
test  of  the  experimentum  crucis  / but  I prefer  to  exa- 
mine it  still  further,  and  under  another  point  of  view, 
lest  the  miasmatists  may  think  I have  not  furnished 
them  difficulties  enough  to  solve. 

In  a great  many  parts  of  Kentucky,  Tennessee, 
North  Alabama,  North  Carolina  and  Virginia,  where 
the  country  is  dry  and  ridgy,  and  in  many  places 
quite  elevated,  autumnal  fevers  occur  upon  the  high- 
est lands,  where  there  is  comparatively  no  moisture, 


62 


ADDRESS  OTT  MALARIA. 


and  where  vegetable  decomposition,  to  the  extent  of 
poisoning  the  atmosphere,  is  never  suspected.  Pro- 
fessor Wood  attributes  the  prevalence  of  intermit- 
tent and  remittent  fevers,  under  such  circumstances, 
to  an  unaccountable  epidemic  influence,  and  not  alone, 
to  the  presence  of  marsh  poison  ; for  he  says,  speak- 
ing of  the  effects  of  epidemic  influences : “ Hence, 
probably,  the  late  prevalence  of  intermittent  and  re- 
mittent fevers,  during  the  summer  and  autumn,  in  por- 
tions of  the  middle  and  eastern  States,  in  which  these 
diseases  were  formerly  almost  unknown ; while  the 
circumstances  of  these  regions,  in  relation  to  the  pro- 
duction of  miasmata,  remained,  so  far  as  could  be 
discovered,  the  same  as  in  preceding  years.”  The 
learned  professor  does  not  exactly  acknowledge  here 
the  agency  of  two  separate  and  distinct  causes  for  the 
production  of  one  and  the  same  effect,  for  he  seems 
to  be  fully  aware  how  apparently  inconsistent  this 
statement  is  with  the  previously  expressed  opinion  of 
the  specific  febrile  character  of  miasmata  in  these  dis- 
eases, and  therefore  endeavors  to  reconcile  them,  1 >y 
supposing  that  there  is  always,  and  in  every  place, 
even  in  the  healthiest  situations,  where  there  is  no  un- 
usual amount  of  moisture,  heat  and  vegetation,  and 
where  intermittent  and  remittent  fevers  have  been  hi- 
therto unknown,  a sufficiency  of  exhalation  from  de- 
composing vegetable  matter  to  produce  these  disea- 
ses, if  there  was  only  present  a little  epidemic  yeast 
to  enliven  the  mass.  Now,  this  view  of  the  matter, 


ADDRESS  ON  MALARIA. 


63 


in  my  humble  judgment,  necessarily  leads  to  one  of 
two  conclusions — either  to  the  employment  of  two 
causes  for  one  effect,  which  I have  elsewhere  stated 
to  be  at  variance  with  the  order  and  economy  of  na- 
ture, or  amounts  to  a begging  of  the  question.  But 
let  that  pass. 

Dr.  Carpenter,  of  Louisiana,  before  quoted,  says : 
“East  Feliciana,  and  the  parishes  lying  east  of  it, 
may  be  taken  as  examples  of  this.  These  parishes 
consist  of  high  lauds,  which  constitute  a portion  of 
the  bluff  formation  of  the  south,  and  have  an  eleva- 
tion of  from  one  hundred,  to  two  hundred  and  fifty 
feet  above  the  level  of  the  Mississippi  river  at  that 
point.  The  lands  are  generally  thin  and  covered  with 
open  forests  of  the  long  leaf  pine,  or  with  those  of 
oak,  beech  and  other  trees,  intermixed  with  a growth 
of  the  loblolly  pine,  and  other  species.  This  exten- 
sive region  is  traversed  by  two  or  three  streams  of 
considerable  size,  which  are  generally  bordered  on 
each  side  by  a narrow  stripe  of  low  land.  The  other 
streams  which  are  small,  run  in  narrow  valleys,  and 
are  rarely  bordered  by  swamps  or  marshes,  and  when 
their  waters  dry  up  in  the  summer,  they  leave  their 
beds  generally  well  washed  and  clean,  or  covered  by 
a deposit  of  sand.  In  this  region,  the  climate  is  ob- 
viously drier  than  in  the  low  lands  of  the  delta,  as  is 
shown  by  hygrometrical  tables,  as  well  as  by  the  fact, 
that  here  the  Spanish  moss  is  scarcely  met  with,  while 
in  the  low  lands  it  covers  every  tree,  and  the  growth 


64 


ADDRESS  ON  MALARIA. 


of  this  plant  is  a good  hygrometrical  index.  Not- 
withstanding the  favorable  aspect  of  these  regions,  as 
respects  health,  the  inhabitants  are  very  subject  to 
ague  and  fever,  and  that  too,  is  not  only  the  case 
with  those  living  near  the  streams,  but  is  equally  so 
with  those  residing  in  the  highest,  most  rolling  and 
arid  portions.” 

Dr.  Dunglison  also  informs  us  that  “ The  bilious 
remittent  is  a common  disease  in  every  part  of  Vir- 
ginia, although  more  prevalent  in  the  lower  than  in 
the  upper  country.  In  the  latter,  it  presents  itself  in 
localities  where  we  may  seek  in  vain  for  marshes,  or 
for  anything  resembling  them.” 

This  is  likewise  true  of  the  whole  Maremma  dis- 
trict of  Italy,  which  stretches  from  Leghorn  to'Terra- 
cina,  and  is  a prey  to  these  diseases  in  every  part  of 
it,  notwithstanding  in  many  places  it  is  elevated,  dry 
and  many  miles  distant  from  anything  like  marshes. 

On  the  other  hand,  along  the  south  west  range 
of  mountains,  in  Albemarle  county,  Virginia,  a spur 
of  the  Blue  Bidge,  although  there  are  many  collec- 
tions of  stagnant  water,  mill-ponds  and  meadows,  yet 
intermittents  are  scarcely  ever  seen.  In  this  district 
of  country  too,  the  hemp  is  pretty  extensively  cul- 
tivated, and  notwithstanding  these  ponds  and  mea- 
dows are  made  use  of  for  the  purpose  of  water-rotting 
and  dew-rotting  the  plant,  it  has  never  been  known 
to  produce  miasmatic  disease. 

It  is  likewise  a well  known  fact  that  there  are 


ADDRESS  ON  MALARIA. 


65 


extensive  marshes  on  a portion  of  the  range  of  Cala- 
brian mountains,  which  were  formerly  covered  with 
forest,  but  which  are  now  cultivated,  upon  which 
marshes,  thick  fogs  or  mists  are  always  to  be  found 
during  the  night  and  early  hours  of  the  morning  ; yet 
the  peasants  sleep  with  impunity  along  the  margins 
of  them,  and  even  the  proprietors  remain  in  their  im- 
mediate vicinity  during  summer  and  autumn  without 
injury. 

Dr.  Robert  Jackson,  in  his  work  on  the  diseases 
of  the  West  Indies,  informs  us,  that  the  same  fevers 
occur  in  those  islands  amongst  the  series  of  mountain 
ridges,  not  exposed  to  the  exhalations  from  swampy 
and  low  grounds,  and  at  an  elevation  of  six  or  seven 
hundred  feet  above  the  level  of  the  sea ; and  Dr. 
Jas.  Johnson,  in  his  work  on  tropical  climates,  asserts, 
that  these  diseases  prevail  in  the  high  hills  and  thick- 
ly wooded  parts  of  the  mountain  ridges  of  the  island 
of  Ceylon,  and  on  the  secondary  mountains  and  pri- 
mitive ridges  in  Sicily  ; while  Dr.  Ileyne  attempts  to 
account  for  their  occurrence  amongst  the  rocky,  w'ood- 
ed  hills,  in  the  Madras  Presidency,  distant  from  any 
acknowledged  source  of  miasms,  by  supposing  them 
to  be  owing  to  some  magnetic  influence,  dependent 
upon  the  ferruginous  character  of  the  rocks. 

Fourcault  also  mentions,  in  his  work  on  chro- 
nic diseases,  that  “ the  mountains  surrounding  the 
Agro  Romano,  at  Tivoli,  Subiac,  and  Terni,  are  sick- 
ly, notwithstanding  there  are  no  marshes  about  them.” 
5 


66 


ADDEESS  ON  MALAEIA. 


And  Wortabet  says,  in  his  fevers  of  Syria,  “ that  the 
town  of  Hasbeyah,  situated  on  one  of  the  high  hills 
near  Mount  Hermon,  and  distant  twenty-five  miles 
from  the  marshy  plains  of  Huleli,  is  a notorious  place 
for  intermittents  of  the  most  obstinate  character 
which  we  have  ever  seen,”  while  “the  villages  which 
are  situated  between  it  and  the  marsh  are,  on  the 
whole,  remarkably  healthy.” 

In  the  same  manner,  other  distinguished  observ- 
ers have  insisted  that  these  diseases  have  been  known 
to  originate  and  prevail  extensively  in  argillaceous 
soils,  where  no  vegetable  putrefaction  was  going  on, 
or  at  all  suspected.* 

The  celebrated  Linnseus  contended,  in  his  inau- 
gural essay,  that  periodical  fevers  originated  in  all 
those  places  where  the  soil  abounds  in  clay,  and  only 
in  such  places  ; and  Von  Aenvank,  a Netherlander, 
endeavors  to  explain  their  prevalence  in  argillaceous 
soils,  by  supposing  that  clay  possessed  the  property 
of  absorbing  oxygen  from  the  atmospheric  air,  and 
thus  imparing  its  purity. 

But  Dr.  Watson,  in  his  lectures,  thinking  this 
matter  not  so  well  settled,  says : “ No  very  certain  or 
extensive  observations  have  yet  been  made  in  regard 
to  the  kind  of  soil  from  which  the  miasmata  are  most 
apt  to  be  extricated.  That  which  is  loose,  penetra- 
ble, porous  and  sandy,  appears  highly  favorable  to 
their  formation.  So  are  soils  which  containing  much 
clay  are  very  retentive  of  moisture.” 


’Ghisholmn,  -Brown  and  others. 


ADDRESS  ON  MALARIA. 


67 


From  Dr.  Dunglison,  we  learn  that,  in  the  sum- 
mer and  autumn  of  1828,  the  high,  ridgy  and  beauti- 
ful shores  of  Long  Island,  known  as  the  Narrows,  re- 
ceived a fearful  visitation  from  intermittent  and  re- 
mittent fevers,  without  any  assignable  cause  for  it, 
and  when  scarcely  a single  case  of  either  had  been 
known  there  for  forty  years  previously ; nor  does  it 
appear,  says  the  Doctor,  to  have  prevailed  there  since. 
The  same  thing  has  occurred  upon  the  island  of  Port- 
sea,  on  which  Portsmouth,  in  England,  is  situated. — 
Many  years  ago,  it  was  believed  to  be  entirely  freed 
from  malarious  diseases  by  drainage ; but  they  have 
recently  returned  again,  not  only  to  the  best  drained 
portions  of  the  Island,  but  even  to  parts  of  it  which 
were  never  before  subject  to  them.  So,  in  our  own 
State,  in  1846,  1847  and  1848,  districts  of  country, 
hitherto  exempt  from  autumnal  fevers  were  terribly 
scourged  by  them,  notwithstanding  there  was  no  ap- 
parent difference  in  the  amount  of  moisture,  heat  and 
growth  of  vegetable  matter,  from  what  was  usual  in 
such  places.  The  tract  of  country  dividing  the  wa- 
ters of  Roanoke  and  Tar  Rivers,  and  extending  from 
the  neighborhood  of  Weldon  on  the  former  river, 
through  portions  of  the  counties  of  Halifax,  Warren, 
Franklin,  Granville  and  Person,  having  an  argillace- 
ous and  gravelly  soil,  with  white  and  red  quartz  and 
granitic  formation,  the  purest  and  finest  springs  and 
wells  of  water,  and  with  a growth  chiefly  of  oak, 
hickory  and  dogwood,  was,  during  these  years,  visited 


68 


ADDRESS  ON  MALARIA. 


by  autumnal  diseases,  and  in  many  places  through 
this  region,  old  men,  heads  of  large  familes,  who  had 
never  taken  a dose  of  medicine  or  seen  a case  of  ague 
and  fever,  or  bilious  fever,  in  their  lives,  became  as 
familiar  with  these  disorders  and  their  treatment  as 
with  household  words.  Other  portions  of  our  State, 
extending  even  into  the  gorges  of  the  mountains, 
heretofore  unfrequented  by  these  maladies,  suffered  in 
a like  unaccountable  manner. 


These  are  some  of  the  facts  and  circumstances 


which  have  induced  me  to  abandon  the  miasmatic  hy- 
pothesis ; for,  whatever  this  febrific  agent  may  be,  if 
different  from  the  appreciable  states  of  the  atmos- 
phere and  the  earth’s  surface,  it  cannot  be  traced,  as 
I think  I have  conclusively  shown,  by  the  presence  of 
those  conditions  of  moisture,  heat  and  vegetation, 
which  are  claimed  as  indispensable  for  its  production. 
Nor  has  any  chemical  analysis,  so  far,  been  able  to  de- 
tect it ; nor  microscopic  investigation,  although  con- 
ducted with  all  the  diligence  and  zeal  incident  to  a 
fashionable  pursuit,  as  yet  revealed  it. 

M.  Julia,  a writer  of  considerable  distinction  on 
marsh  miasm,  assures  us  that,  after  sixty  trials  to  de- 
tect the  chemical  and  physical  properties  of  this  poi- 
son in  the  air  of  several  very  insalubrious  marshes, 
by  the  most  searching  analysis,  in  each  instance  he 
found  only  such  constituent  principles  as  are  contain- 
ed in  the  purest  atmospheric  air. 

Moschati  and  Broschi  also  examined  analytically 


ADDRESS  ON  MALARIA. 


69 


the  air  of  rice  fields,  and  some  notoriously  unhealthy 
spots  in  the  papal  States,  with  nearly  like  results ; 
while  u M.  Deseye  obtained,  in  the  most  confined  and 
unhealthy  marshes,  as  on  the  most  exposed  hills,  se- 
venty-eight parts  of  Nitrogen,  twenty-one  of  Oxygen, 
and  one  of  Carbonic  acid.” 

And  Dr.  Minzi,  of  the  Central  Hospital  of  Ter- 
racina,  with  a view  to  determine  whether,  in  the  ge- 
nesis of  paludal  fevers,  there  was  really  any  special 
miasmatic  principle,  collected,  by  means  of  an  appa- 
ratus containing  a frigorific  mixture,  the  dew  which 
fell  in  the  vicinity  of  Rome  and  Terracina.  Of  this 
he  and  several  other  persons  drank  portions  varying 
from  ozij  to  ozvj,  without  any  ill  consequences.— 
’Wounds  on  the  legs  of  two  peasants  were  also  washed 
with  the  dew  water,  without  any  bad  effect.  He  con- 
cludes, therefore,  that  the  miasmatic  principle,  if  any 
such  exist,  does  not  reside  in  the  dew  of  malari- 
ous districts,  notwithstanding  the  universal  opinion 
amongst  the  regular  miasmatist,  that  the  moisture  of 
the  air  in  such  situations,  when  precipitated  at  night 
in  the  form  of  dew,  always  carries  the  miasmata  with 
it,  which  have  been  floating  in  the  atmosphere  during 
the  day. 

Such  is  the  view  of  this  subject  which  I have 
thought  proper  to  present  for  your  consideration ; and 
these  the  facts  which  the  brief  space  allotted  to  an 
address  of  this  kind  has  permitted  me  to  bring  for- 
ward in  support  of  my  position.  Nevertheless,  I be- 


10 


ADDRESS  ON  MALARIA. 


believe  they  will,  under  the  operation  of  the  rule 
which  I have  laid  down  for  our  government  in  the 
study  of  all  questions  in  physical  etiology,  the  scien- 
tific value  and  applicability  of  which  no  one  can 
deny,  furnish  sufficient  evidence  to  convince  us  that 
there  is  no  truth  in  the  doctrine  of  the  miasmatic  origin 
of  disease. 


- 

- 


AN  ADDRESS 

DELIVERED  RE  FORE  THE 

MEDICAL  SOCIETY  OF  NORTH  CAROLINA, 

AT  ITS 

Mr.  President  and  Gentlemen 

of  the  Medical  Society  of  the  State : 

It  was  my  purpose  to  make  this  communication 
to  you  at  the  last  Annual  Meeting  in  Fayetteville, 
but  circumstances  of  a pressing  nature  prevented  my 
attending  that  meeting  ; and  as  I preferred  reading  to 
the  Society,  first  of  all,  my  remarks  in  reply  to  Dr. 
Satch  well’s  strictures  upon  my  address,  delivered  here 
three  years  ago,  it  will  be  readily  understood  why 
they  have  not  been  made  public  before. 

In  that  address,  I emphatically  stated  that  I was 
submitting  for  your  consideration  the  chief  evidence 
on  which,  against  the  early  convictions  of  education, 
I was  first  led  to  doubt,  and  finally  to  reject,  a doc- 
trine sanctified  by  the  lapse  of  ages,  and  supported  by 
many  great  authorities  in  ancient  and  modern  medi- 
cine. And  being  fully  aware,  that  in  these  times,  no 
proposition  in  medical  philosophy  is  mooted  which 
does  not  become  a subject  of  controversy,  where 
every  statement  is  met  by  a plausible  counter  asser- 


74 


ADDEESS  ON  MALAEIA. 


tion,  I also  stated  that,  in  conducting  an  inquiry  of  so 
great  practical  importance  to  the  skilful  and  scientific 
physician,  the  mere  dicta,  unaccompanied  by  satisfy- 
ing proof,  of  the  most  eminent  men  in  our  profes- 
sion, whose  well-established  reputation  even,  would 
lend  interest  to  any  question  they  might  advocate, 
should  not  deter  me  from  faithfully  investigating 
truth. 

In  my  zeal,  I may  have  been  mistaken  in  the  es- 
timate I formed  of  the  value  ot  these  premises ; but 
as  the  obligation  of  candor  is  imposed  on  all  honest 
inquirers,  having  conscientiously  formed  that  estimate, 
its  expression  was  a matter  of  course.  Since  then,  how- 
ever, I have  seen  no  reason  to  alter  my  determination. 
If  my  argument  was  not  established  on  the  basis  of 
sound  reasoning,  and  supported  by  the  foundations  of 
truth,  let  it  fall.  But  having  written  in  a true  Catho- 
lic spirit,  if  anything  therein  set  forth  has  served  to 
fix  the  attention  of  my  brethren,  and  to  fasten  in- 
vestigation upon  the  subject  of  the  miasmatic  origin 
of  disease,  I am  satisfied  that  I have  discharged  a 
duty  to  the  profession,  and  am  willing  to  wait  its  final 
judgment. 

I shall  not  stop,  therefore,  to  try  compliments 
with  Dr.  Satchwell,  nor  to  notice  whatever  of  a 
personal  nature  may  be  found  in  his  pages.  It 
is  beside  the  question,  and  would  be  in  very  bad 
taste. 

Nor  do  I mean  to  occupy  much  of  your  time 


ADDKESS  ON  MALARIA. 


?5 

with  discussing  the  subject  of  progress  and  improve- 
ment. But  one  thing  is  certain,  that  from  the  day 
when  organization  first  commenced  upon  the  surface 
of  the  earth,  the  law  which  it  has  followed  has  been 
a law'  of  progress  and  improvement.  Countless  thou- 
sands of  living  forms  have  been  produced,  and  we, 
the  last,  are  the  highest  and  most  perfect.  But,  even 
with  us,  knowledge  and  power  are  incessantly  advanc- 
ing, and  where  intelligence  has  been  given,  the  law 
absolutely  requires  of  its  possessors  to  join  in  the  ad- 
vancing march  of  mind,  or  die  the  death  of  ignorance 
and  forgetfulness.  The  poor  miserable  Indian,  stand- 
ing still,  amidst  this  fonvard  movement,  suffers  the 
penalty  of  this  lavr,  and  will  be  blotted  from  the  re- 
membrance of  the  peoples  of  the  earth,  for  he  dies 
“umvept,  unhonored  and  unsung.” 

The  law  of  progress  and  improvement,  then,  is 
the  great  law  of  nature,  physical  and  moral.  Even 
in  religion,  the  Jewish  Dispensation  only  made  wmy 
for  the  Christian’s  more  enduring  faith  and  brighter 
hope.  And  so  it  cannot  be  denied  but  that  all  those 
important  ideas  and  great  truths  which  now  consti- 
tute modern  science,  wrere,  in  their  origin,  obscurely 
and  imperfectly  set  forth.  Propositions  delivered  to 
us  by  the  ancients  as  true,  and  seemingly  infallible, 
when  viewed  under  the  partial  conditions  and  limita- 
tions w'hich  circumscribed  the  field  of  their  observa- 
tions, become  absolutely  and  palpably  false,  wdien 
transferred  to  other  localities,  or  are  merged  in  more 


76 


ADDRESS  ON  MALARIA. 


general  and  comprehensive  problems.  In  our  philo- 
sophy of  causes,  the  extension  of  our  facts  enlarges 
the  sphere  of  our  observation  and  the  basis  of  our 
principles,  thus  enabling  us  to  dissolve  those  errors 
which  arise  from  a limited  and  narrower  field  of  ope- 
rations, by  the  broad  and  unerring  light  of  a more 
general  and  universal  truth. 

It  was*  not  given  to  the  human  mind,  when  it 
emerged  from  mediaeval  darkness  and  ignorance,  any 
more  than  it  was  given  to  the  human  eye,  when  it 
comes  out  of  physical  darkness  into  sunshine,  to  see 
all  objects,  even  those  directly  before  it,  in  tbeir  pro- 
per aspects  and  true  relations.  As  in  the  one  in- 
stance, a period  of  time  must  elapse  before  the  eye 
becomes  accustomed  to  this  flood  of  light,  so,  in  the 
other,  it  has  required  centuries  for  the  human  mind 
to  see  and  understand  those  wonderful  phenomena,  in 
their  complicated  relationships  as  causes  and  effects, 
which  constitute  the  basis  and  superstructure  of  our 
philosophy. 

Upon  this  question,  Dr.  Satchwell  has  taken  his 
own  position,  with  his  back  to  the  future,  and  his  face 
to  the  past,  for  the  purpose,  as  he  says,  of  perfuming 
the  memories  of  the  illustrious  dead,  especially  of 
Laneisi,  who  teaches,  according  to  him,  “ that  heat, 
moisture  and  vegetable  decomposition,”  produce  peri- 
odical fevers. 

Now,  Laneisi  wrote  at  the  very  end  of  the  17th 
century,  and  it  svas  the  office  of  the  whole  of  the  18th 


ADDRESS  ON  MALARIA. 


77 

century,  and  of  a portion  of  tlie  present  or  19th, 
to  lay  the  foundations  of  physics,  or  of  that  group  of 
scientific  observations  which  embrace  ultimate  ele- 
ments, and  the  relationships  and  reactions  of  atoms. 
It  could  not  be  expected  of  Lancisi,  therefore,  to 
know  much  of  physics  in  its  most  enlarged  and  com- 
prehensive sense  ; and  accordingly,  although  I am 
not  much  disposed  to  moot  propositions  of  so  remote 
a character,  I intend  to  show,  in  the  course  of  my  re- 
marks to-day,  that  such  was  the  fact ; and  further, 
that  he  did  not  teach  “ that  heat,  moisture  and  vege- 
table decomposition”  produce  an  effluvium,  which  is 
the  specific  cause  of  periodical  fevers. 

What  did  Lancisi  know  of  Chemistry  and  Phil- 
osophy, as  we  understand  them  ? Did  he  know  any- 
thing of  the  compound  constitution  of  the  atmos- 
phere ? And,  being  ignorant  of  that,  how  could  he 
understand  the  function  of  respiration,  and  the  true 
actions  of  the  skin  ? Did  he  know  anything  of  Elec- 
tricity, Galvanism  and  Magnetism,  and  of  their  cor- 
relation with  heat  and  light,  thus  becoming  the  great 
motive  principles  of  the  universe  ? Did  he  under- 
stand the  proper  functions  of  the  brain,  great  sym- 
pathetic, spinal  marrow,  and  the  reflex  actions  of  the 
nerves  ? Certainly  not.  And  yet  Dr.  Satchwell 
says,  speaking  for  himself,  of  course,  and  not  for  us, 
that  being  “ young  in  medical  observation  and  expe- 
rience, we  know  of  no  better  lights  to  guide  us,  than 
was  (were  ?)  given  by  the  illustrious  and  philosophic 
Lancisi.” 


78 


ADDRESS  ON  MALARIA. 


Considering,  then,  the  brilliant  discoveries  which 
have  illumined  the  walks  of  the  chemist  and  his* 
tologist,  and  how  much  the  condition  of  the  natu- 
ral sciences — especially  those  pertaining  to  the  philo-' 
sophy  of  Life— has  been  altered  and  changed  since 
the  opening  of  the  last,  and  during  the  present  cen- 
tury, we  ought  not,  I think,  to  repose  too  much  con- 
fidence in  the  philosophic  opinions  of  Lancisi.  Since 
his  time,  the  various  agents  which  affect  for  good  or 
evil  our  complex  organization,  have  been  thoroughly 
and  reciprocally  illustrated,  by  being  rendered  more 
definite  in  character  and  precise  in  their  relations. — 
We  have  been  supplied  with  more  new  elements,  and 
safer,  better  methods  of  investigation,  than  were 
known  to  this  celebrated  Italian  physician,  who  wrote 
his  treatise  De  Noxiis  Paludum  Effiuviis,  in  1695, 
when,  from  the  necessary  imperfection  in  all  chemical 
and  philosophical  inquiries,  it  was  impossible  for  him 
truthfully  to  record  any  other  determination  upon 
the  subject  under  discussion,  than  that  swamps  and 
marshes,  generally  speaking,  are  more  sickly  than  the 
high  lands.  This  fact,  which  I have  never  denied, 
Lancisi  verified  by  observation  ; but  strange  as  it 
may  appear,  he  nowhere  inculcates  the  abstract  idea, 
that  an  emanation  from  decaying  vegetable  matter, 
is  the  specific  cause,  one  and  indivisible,  of  periodical 
fevers.  Indeed,  he  had  very  indefinite  ideas,  both  of 
the  nature  and  effects  of  this  marsh  effluvium,  for  he 
says : “ They  are  not  everywhere  and  constantly  the 


ADDRESS  ON  MALARIA. 


79 


same,  nor  is  their  constitution  always  identical ; and 
they  cannot  all  be  individually  comprehended  in  one 
and  the  same  species.”  “ JVo/i  ubique  et  semper  eadem 
sunt  ejus-demque  materice  et  singulos  sub  una  eadernque 
specie  comprehendi  non  passed  Again : “ There  are 
carried  into  the  air  various  kinds  of  corpuscles  or  par- 
ticles held  in  solution,  and  connected  rather  by  acci- 
dent than  by  definite  laws,  which,  on  being  received 
into  our  body,  produce  greater  or  less  disturbance  in 
it,  according  as  they  have  been  variously  tempered 
together,  or  as  they  may  even  approach  the  nature 
of  a poison.”  “ Vania  quoque  in  aerem  ferri  corpus - 
quia,  sen  particidas  solutas , et  casu  potius  quam  certa 
lege  s-ocietas , pace,  in  nostrum  corpus  ingestce, , minorem 
net  majorem  noxam  inferunt  prout  minus  vel  minime 
inter  se  temperatce , aut  etiam  ad  veneni  prope  naturam 
evectce  sunt  ” But  elsewhere  he  distinctly  asserts  that 
there  are  at  least  two  kinds  of  poisonous  effluvia  from 
marshes,  the  one  inorganic,  and  the  other  organic. — 
The  inorganic  is  “ an  accumulation  of  dead  and  inor- 
ganic particles,  with  impure  sulphur,  and  acrid  and 
volatile  salts,  with  other  extraneous  matters,  which 
being  densely  evolved  in  the  exhalations  from  the 
waters,  affect,  in  a very  unpleasant  manner,  the  sense 
of  smell.  The  other  genus  of  effluvia  is  composed  of 
a multit  ude  of  worms  and  ova , which  float  about  in 
the  atmosphere,  a distinct  host  of  aerial  animalcula.” 
“ Altarum  quidam  est  congeries  inorganicarum  atque 
manimarum  particularum  impuri  sulphur  is,  solium- 


80 


ADDRESS  ON  MALARIA. 


pue  lixivio  acrium  ac  volatilium , aliorumque  exotico- 
rum , yttce,  aquiis  balitibus  crass e obvolutw , ingratum 
etiarn  naribus , empyreuma  propinant.  Alterurn  vero 
ejjluoiorum  genus  constant  multitudine  vermicLilorum 
atque  ovulorum quasi  agrnen  instruuntur  in  acred 

Here  Henry  Holland  and  others  might  find,  in 
“ the  illustrious  and  philosophic  Lancisi,”  an  advocate 
for  their  theory  of  the  animalcular  origin  of  disease, 
which  Dr.  Satc-hwell,  in  his  essay,  disposes  of  in  the 
most  summary  manner,  without  once  supposing,  I am 
sure,  that  his  ancient  friend  In  Id  such  dogmas.  Yet, 
Lancisi,  doubtless  for  the  purpose  of  fortifying  his 
doctrine  as  to  the  insect  origin  of  disease,  refers,  with 
evident  satisfaction,  to  the  opinions  of  Vatro,  Col- 
umello  and  Vitruvius,  and  speaks  of  a host  of  ani- 
malcules, not  appreciable  by  the  eye — (“  quae  non 
possant  oculi  conssqiu ’) — but-  which  are  capable  of 
insinuating  themselves  into  our  bodies,  through  the 
mouth  and  nostrils,  and  of  producing  serious  diseases 
— diffisiles  rnorbos  /”  and  he,  also,  speaks  of  the  nox- 
ious influence  of  “ the  winds  and  flatulent  discharges 
and  exhalations  thrown  off  by  these  insects.”  “ Sed 
in  jiatibus  collocat  exhcdationibus  ab  iisdern  insect  is  p> 
tissimus  e miss  is  d 

In  regard  to  the  morbific  effects  of  these  effluvia, 
Lancisi  inclines  to  the  belief,  that  the  inorganic  por- 
tion can  scarcely  be  considered  of  itself,  a cause  of  dis- 
ease, whilst  the  organic  or  animalcular  portion  affects 
our  bodies  chiefly  in  a three-fold  manne  : 


ADDRESS  ON  MALARIA. 


81 


“ 1st  By  mere  irritation,  and  by  tlie  wounds 
they  inflict. 

2nd.  What  is  more  serious,  by  mingling  their 
corrupt  juices  with  the  fluids  of  our  own  bodies. 

3rd.  Lastly,  by  affording  nourishment  to  the 
parisitic  intestinal  worms.” 

“ Primo  / Per  se  ipsa  irritando , vulnerando  que. 

Secundo  ; Quod  forte  determs  est  pravos  suas  suc- 
cos  cum  nostris  Uquidis  permiscendo . 

Tertio;  Denique  indigenas  lumbricos  nutriendo 
sagvnendoque? 

So  much  for  Lancisi’s  ideas  of  the  nature  and 
mode  of  action  of  the  marsh  effluvia,  which,  differing 
very  much  in  their  chemical  and  physical  character, 
produce,  he  says,  a diversity  of  diseases  besides  peri- 
odical fevers.  These  latter  disorders  are  not  always 
brought  on,  he  thinks,  by  miasmas,  but  may  be  in- 
duced by  “ checking  the  perspiration,  by  which  the 
noxious  and  useless  matters,  which  otherwise  accumu- 
late in  the  system,  ought  to  be  carried  off  from  the 
body.”  “ Unde  fit,  ut  (pice  nostris  e corporibus  pers- 
pera/ri  deberent  vel  noxia , vel  saltern  inutilia  corpuscula 
magnam  partem  proliibenter  ejfiuered  And  further, 
“ that  a wind  from  any  quarter,  however  salubrious 
it  may  be,  is  adequate  to  produce  this  malady  (inter- 
mittent fever)  by  the  force  of  its  current  alone.” — 
Quamobrem  guilibet  ventus , tametsi  saluberrimus,  ma- 
lum istud  sola  impulsionis  vi  producere  valet.” 

Thus,  whatever  importance  Lancisi  may  have 
6 


82 


ADDRESS  ON  MALARIA. 


attached  to  the  morbific  influence  of  marsh  miasms, 
and  however  heterogeneous  in  their  essential  constitu- 
tion he  may  have  considered  them,  he  evidently  did 
not  believe  that  periodical  fevers  could  not  arise  from 
other  causes  than  this  contamination ; for  he  distinct- 
ly states  that  a check  of  perspiration,  which  prevents 
the  escape  of  the  peccant  humors  from  the  system, 
will  induce  these  diseases ; and  that  the  purest  breezes, 
tametsi  saktberrimus , no  matter  from  what  quarter 
they  may  blow,  are  adequate  to  produce  them. 

However,  I shall  now  take  leave  of  Dr.  Sateh- 
well’s  notions  about  progress  and  improvement,  after 
commending  him  to  a careful  husbandry  of  his 
strength  and  resources,  as  the  race  before  him  leads  a 
long  way  backwards,  satisfied  the  while,  although  by 
virtue  of  his  learning  and  zeal  he  may  be  able  to 
make  considerable  progress,  that  the  universal  opini- 
on will  be  his  movement  is  retrogade,  and  not  onward 
with  that  advanced  corps  of  scientific  investigators, 
who  are  marching  forward  with  increasing  and  ex- 
panding intelligence.  Nullum  vestigium  retror- 
sum. 

But  let  us  proceed  to  the  discussion  of  our  sub- 
ject, which  I propose  to  do,  by  noticing  the  facts  and 
arguments  of  Dr.  Satchwell,  under  the  three  follow- 
ing heads,  to  wit : 

First.  He  has  failed  to  show  that  the  periodical 
diseases  which  prevail  in  high,  ridgy  and  mountain- 
ous districts,  and  other  situations  free  from  swamps 


ADDRESS  OX  MALARIA. 


83 


and  marshes,  are  owing  to  an  emanation  from  decom- 
posing vegetable  matter. 

Secondly.  He  has  utterly  failed  to  prove  the  sa- 
nitary properties  of  salt  mixing  with  fresh  water,  un- 
der circumstances  that  would  certainly  produce  mi- 
asmatic diseases,  were  the  salt  water  absent. 

Thirdly.  His  statements  are  incorrect  with  re- 
gard to  the  Roanoke  country,  and  some  of  the  swamp 
lands  of  our  State. 

Under  these  three  heads  may  be  comprised  all 
the  main  features  of  Dr.  Satchwell’s  address  that  are 
pertinent  to  this  inquiry. 

Dr.  Satchwell  endeavors  to  account  for  the  mi- 
asmatic origin  of  fevers  in  elevated  situations,  and 
other  places  free  from  swamps  and  marshes,  by  quo- 
tations from  the  works  of  Drs.  Wood,  James  John- 
son, Irvine  and  Holmes.  How,  for  the  purpose  of  ar- 
riving at  the  true  value  and  real  importance  of  their 
opinions  in  the  premises,  I shall  endeavor  to  ascertain, 
in  the  first  place,  whether  they  carry  with  them  satis- 
fying proof  of  the  truth  of  the  doctrine,  or  are  only 
pure  hypotheses — mere  conjectures — unsupported  by 
such  facts  and  conditions  as  should  constitute  the  pro- 
per basis  of  every  philosophical  inquiry.  And,  in  the 
second  place,  try  and  find  out  by  cross-examining  these 
witnesses,  who  have  been  brought  forward  so  impos- 
ingly to  enlighten  our  minds,  and  fortify  our  judg- 
ments upon  this  vexed  question,  whether  even  they 


84 


ADDRESS  ON  MALARIA. 


believe  in  the  truth  and  sufficiency  of  their  own  views 
as  therein  set  forth. 

First,  then,  of  Dr.  Wood,  the  learned  Professor 
of  the  University  of  Pennsylvania,  who  says : “ It 
is  well  known  that  most  soils,  even  when  to  the  eye 
they  show  no  trace  of  vegetable  matter,  yet  abound 
in  seeds  of  various  plants,  often  even  at  great 
depths  ; and  peculiar  circumstances  may  lead  to 
their  decomposition,  and  the  consecpient  exhalation 
of  volatile  products,  though  no  such  result  may  be 
obvious.” 

Now  such  products  must  be  hydrogenated,  car- 
buretted,  and  ammoniacal  gases ; yet  it  has  never 
been  shown  in  all  the  extensive  and  diligent  researches 
which  have  been  instituted  upon  the  subject,  that 
either  one  of  these  gases  singly,  or  any  combination 
of  them  even,  has  been  the  cause  of  fever.  On  the 
contrary,  it  has  been  satisfactorily  proven  that  per- 
sons exposed  to  these  gases,  in  large  manufacturing 
establishments,  are  generally  more  healthy,  or  cer- 
tainly no  more  liable  to  intermittents  and  remittents, 
than  those  who  have  not  been  under  the  influence  of 
such  exhalations. 

But  why  did  not  Dr.  Wood  state,  what  I under- 
take to  assert,  no  one  will  deny,  and  what  he  else- 
where teaches,  namely  : that  all  natural  soils  abound 
in  vegetable  matters,  though  not  evident  to  the  eye, 
and  then  inform  us  what  “ peculiar  circumstances- — 
for,  being  “ peculiar,”  they  must  be  different  from  the 


ADDRESS  ON  MALARIA. 


85 


common  ones,  lieat  and  moisture— may  produce 
their  decomposition.”  In  so  doing,  he  would  have 
made  a real  and  substantial  contribution  to  medical 
etiology,  and  rendered  a great  and  acceptable  service 
to  suffering  humanity.  Then  we  should  know  when 
and  where  to  expect  these  miasmatic  diseases,  provi- 
ded it  is  only  necessary  to  have  an  emanation  from 
decomposing  vegetable  matter  to  produce  them ; 
whilst  in  our  present  state  of  ignorance  upon  this 
subject,  it  is  by  sad  and  lamentable  experience  alone 
we  are  taught  that  many  apparently  delightful  regi- 
ons of  country,  where  there  are  no  marshes  or  swamps, 
with  their  smiling  table  lands  and  verdant  fields,  so 
capable,  under  the  hand  of  industry,  of  ministering 
to  man’s  wants  and  comforts,  are,  nevertheless,  occu- 
pied by  an  invisible  enemy,  whose  baneful  influence 
renders  all  these  advantages  worthless. 

Moreover,  how  does  Dr.  Wood  know  of  the 
“ exhalation  of  volatile  products,  though  no  such  re- 
sult may  be  obvious,”  consequent  upon  vegetable  de- 
composition, brought  about  by  other  circumstances 
than  heat  and  moisture?  And  more  than  all,  how 
does  he  know  that  these  “ volatile  products”  are  ca- 
pable of  producing  disease  ? Certainly,  such  an  opi- 
nion is  xlirectly  at  variance  with  the  following  extract 
from  the  same  work,  which  was  quoted  by  Dr.  Satch- 
well:  “ The  circumstances,”  says  Dr.  Wood,  “which 

appear  to  be  essential  to  the  production  of  miasmata 
are  heat,  moisture  and  vegetable  decomposition.” — 


86 


ADDRESS  OK  MALARIA. 


What,  then,  becomes  of  the  “ peculiar  circumstances7’- 
which  Dr.  Satchwell  so  earnestly  insists  afford  us  a sa- 
tisfactory solution  of  the  difficulty  in  hand  ? Why 
clearly,  in  the  estimation  of  Dr.  Wood  himself,  the 
u peculiar  circrum-staiicets''  become  non-essentials — en- 
tirely worthless — so  far  as  the  production  of  miasma- 
ta is  concerned  ; while  the  “ volatile  products,”  which 
result  from  their  action  on  vegetable  matter,  a for- 
tiori, not  being  miasmata,  are  without  value  in  this 
inquiry. 

In  another  part  of  this  work,  dissatisfied,  evident- 
ly, with  the  above  explanation,  Dr.  Wood  attributes 
the  occurrence  of  miasmatic  fevers  in  situations  gene- 
rally healthy,  or  where  they  have  been  hitherto  un- 
known, to  the  action  of  an  epidemic  poison  on  the 
miasms,  a sufficiency  of  which  exhales  from  every  soil, 
and  in  every  situation,  to  produce  disease,  when  aid- 
ed in  this  manner.  Thus  speaking  of  epidemic  influ- 
ence, he  says  : “ Hence,  probably,  the  late  prevalence 
of  intermittent  and  remittent  fevers,  diming  the  sum- 
mer and  autumn,  in  portions  of  the  Middle  and  Eas- 
tern States,  in  which  these  diseases  were  formerly  al- 
most unknown ; while  the  circumstances  of  these  re- 
gions, in  relation  to  the  production  of  miasmata  re- 
mained, so  far  as  could  be  discovered,  the  same  as  in 
preceding  years.” 

Again,  when  treating  of  irritative  fevers,  he  says  : 
“ In  some  instances,  the  disease  appears  to  assume  the 
intermittent  form.  At  least  I do  not  know  how  oth- 


ADDRESS  ON  MALARIA. 


87 


erwise  to  account  for  those  cases  of  intermittent  fe- 
ver, which  we  sometimes  meet  with  in  situations  be- 
yond any  suspicion  of  miasmata,  and  in  individuals 
who,  so  far  as  can  be  ascertained,  have  never  been 
exposed  to  their  influence.'” 

Thus  Dr.  Wood  furnishes  us  with  three  distinct 
modes  of  accounting  for  the  occasional  prevalence  of 
periodical  fevers,  in  situations  generally  healthy,  and 
where  there  are  no  unusual  states  of  heat,  moisture 
and  vegetable  decomposition,  which  latter  conditions, 
he  declares,  are  essential  to  the  production  of  mias- 
mata ; yet  Dr.  Satchwell  brings  him  forward  as  a 
competent  witness  to  prove  that  a specific  poison,  one 
and  indivisible,  emanating  from  vegetable  decompo- 
sition, produces  these  diseases. 

Let  us  now  examine  Dr.  James  Johnson’s  solu- 
tion of  our  difficulty,  and  through  him,  Irvine’s  ex- 
planation of  the  same  subject.  Johnson  says:  “ Wa- 
ter, imbued  with  animal  and  vegetable  matters,  may 
sink  into  the  soil,  and  either  remain  there,  or  perco- 
late under  the  surface  till  it  finds  an  issue  in  a spring 
or  river.  This  is  known  to  be  the  case  in  numerous 
instances,  and  in  almost  every  country.”  He  further 
declares,  that  pestiferous  emanations  may  exhale  from 
it  through  the  cracks  in  the  surface  of  the  earth,  du- 
ring the  hot  dry  months  of  summer  and  autumn. — 
“ Thus  (says  Irvine)  some  places  in  Sicily,  though  on 
very  high  ground,  are  sickly ; as  Ibesso  or  Gresso, 
about  eight,  miles  from  Messina,  situated  upon  some 


88 


ADDRESS  ON  MALARIA. 


secondary  mountains  lying  on  the  side  of  the  Primi- 
tive Ridge  which  runs  northward  toward  the  Faro. — 
It  stands  very  high,  hut  still  there  is  some  higher 
ground  at  some  miles  distance.  W ater  is  scarce  here, 
and  there  is  nothing  like  a marsh.”  Here  we  have 
another  extraordinary  conjecture,  quite  different  from 
those  given  by  Prof.  Wood,  although  none  the  less 
hypothetical,  to  account  for  the  generation  of  marsh 
poison  in  the  highlands  and  mountains,  where  “ water 
is  scarce,  and  there  is  nothing  like  a marsh.”  This, 
however,  was  necessary,  since  it  was  ascertained  by 
observation,  that  the  highlands  of  Sicily,  remote  from 
every  thing  like  swamps  and  marshes,  were  as  sickly 
as  the  lowlands*  The  human  mind,  therefore,  fruitful 
in  expedients,  but  in  this  instance,  determined  to  ad- 
here to  the  old  theory,  that  an  exhalation  from  de- 
composing vegetable  matter,  is  the  specific  cause  of 
periodical  fevers,  set  to  work  to  frame  an  explana- 
tion that  would  square  with  this  doctrine.  Unfortu- 
nately for  its  friends,  however,  it  carries  the  stamp  of 
absurdity  upon  its  very  face,  besides  being  directly 
at  variance  with  the  opinion  of  Dr.  Johnson,  in  his 
work  on  Tropical  climates,  where  he  says  : “ Experi- 
ence and  observation  have  proved  that  these  febrific 
exhalations  arise  from  the  summits  of  mountains , as 
well  as  from  the  surface  of  swamps.  The  mountains 
of  Ceylon,  covered  with  woods  and  jungles,  and  the 
vast  ghauts  themselves,  give  origin  to  miasmata  that 


♦Smith. 


ADDRESS  OK  MALARIA. 


89 


occasion  precisely  the  same  fevers  as  are  witnessed  on 
the  marshy  plains  of  Bengal.” 

Thus  there  is  no  “ higher  ground  at  some  miles 
distance,”  in  Ceylon,  to  send  down  a supply  of  water 
to  furnish  “ these  febrific  exhalations,”  for  they  “arise,’5 
says  Dr.  Johnson,  “ from  the  summits  of  mountains  as 
well  as  from  the  surface  of  swamps? 

But  how  can  any  one  believe  for  a moment,  who 
reflects  seriously  upon  this  subject,  that  the  rain, 
which  falls  upon  the  mountain  tops,  where  there 
are  no  marshes,  swamps  or  stagnant  pools,  in  perco- 
lating through  the  soil  to  find  its  way  to  the  ocean, 
thus  forming  the  veins  of  water  in  the  earth,  which 
supply  us  with  our  purest  and  most  wholesome 
springs  and  wells  of  water,  should,  nevertheless, 
throughout  its  course  under  the  surface,  carry  with 
it  so  much  impurity  from  decomposed  vegetable  mat- 
ter, as  to  furnish  the  specific  effluvium,  marsh  poi- 
son, through  every  crack,  and  crevice,  and  piece  of 
plowed  land  that  it  passes  under  ? Can  any  one 
believe  it  ? No ; not  even  Dr.  Johnson  himself. 
Accordingly,  in  the  same  work,  “ Change  of  Air,” 
from  which  these  extracts  were  taken,  but  in  a dif- 
ferent part  of  it,  he  emphatically  so  declares. 
Speaking  of  Pellagra,  he  says:  “The  cause  of  this 
frightful  epidemic  has  engaged  the  pens  of  many 
learned  Doctors.  But  it  is  just  as  inscrutable  as  the 
causes  of  hepatitis  on  the  coast  of  Coromandel — 
Elephantiasis  in  Malabar — Beriberi  in  Ceylon — 


90 


ADDRESS  ON  MALARIA. 


Barbadoes-leg  in  the  Antilles — Goitre  among  the 
Alps — the  Plica  in  Poland — Cretinism  in  the  Val- 
lais,  or  Malaria  in  the  Campagna  di  Roma? 

Furthermore,  in  his  work  on  Tropical  Climates, 
when  speaking  of  Irvine’s  statements  about  the  Fiu- 
mares  in  Sicily,  he  quotes  that  writer  more  at  length, 
and  to  the  effect  of  entirely  destroying  the  applica- 
tion which  is  made  of  his  remarks,  in  his  work  on 
Change  of  Air,  where  the  following,  which  is  only  a 
continuation  of  that  quotation  from  Irvine,  ls  en- 
tirely omitted : “At  this  station,  however,  (that  is, 
Ibesso,  or  Gesso,)  sickness  seldom  occurs,  unless  after 
rains  falling  when  the  ground  is  yet  hot,  which  is 
during  the  heat  of  summer,  or  early  in  autumn,  'when 
all  circumstances  combine  for  the  production  of  Mias- 
mata. I remember,  says  Irvine,  a muleteer  passing 
over  the  hills  near  Ibesso,  in  the  middle  of  August, 
during  a heavy  rain,  who  remarked  that  these  rains , 
falling  on  the  heated  ground, , would  cause-  a stink,  and 
that  many  would  be  poisoned.” 

Thus  another  important  witness  not  only  con- 
tradicts himself  and  fails  to  support  the  cause  he  is 
called  to  sustain,  but,  in  my  humble  judgment,  makes 
against  it  by  declaring  the  cause  of  malaria  to  be 
inscrutable,  unknown,  wliei\  as  Dr.  Satckwell  con- 
tends that  it  is  an  emanation  from  decomposing  vege- 
table matter. 

I will  now  call  your  attenlion  to  what  is  said  of 
Fort  Macomb,  in  Middle  Florida.  Dr.  Satchwell 


ADDRESS  ON  MALARIA. 


91 


says  that,  “ in  general  terms  there  was  no  decaying 
vegetable  matter  about  the  place,” — that  ephemeral 
fungi,  of  an  unhealthy  kind,  and  most  disgusting  and 
nauseous  odor,  flourished  in  great  abundance  about 
the  fort — that  the  moisture  to  produce  these  fungi 
was  obtained  from  a stratum  of  putty-like  clay,  un- 
derlaying the  surface  and  extending  under  the  fort. 
“ Here,”  says  Dr.  Satchwell,  “ was  the  source  of  the 
moisture,  and  here  was  presented  a combination  of 
those  causes  requisite  to  the  generation  of  that  form 
of  malaria,  which  was  necessary  for  the  production  of 
the  disease  which  prevailed  at  the  fort.” 

That  this  locality  was  a very  damp  one  cannot 
be  denied.  Indeed,  from  the  profuse  growth  of 
mushrooms,  which  are  known  to  require  a great  deal 
of  moisture  for  then-  support,  and  from  other  facts 
which  I shall  adduce  from  Dr.  Holmes’  own  statement, 
I intend  to  show  that  this  place,  although  situated  on 
a comparatively  elevated  tongue  of  sandy  land,4  un- 
derlaid with  -mud  and  clay,  between  the  Suwannee 
River,  on  the  one  hand,  and  a small  stream  entering 
into  it  on  the  other,  was,  obviously,  an  excessively 
damp  one,  and  therefore  unsuited  for  a fort  or  dwel- 
ling. It  is  like  many  places  along  the  banks  of  our 
sluggish  streams,  and  in  the  midst  of  some  of  our 
extensive  swamps,  where  we  often  find  knolls  of  sand, 
underlaid  at  varying  depths  of  from  one  to  several 
feet,  by  strata  of  mud  or  stiff  clay,  while  the  surface, 
especially  about  the  roots  of  the  trees,  is  covered  with 


92 


ADDRESS  ON  MALARIA. 


a short  green  moss,  or  a few  mushrooms,  with  the 
bodies  and  branches  of  all  the  trees,  pines  and  oaks, 
constantly  wet,  and  literally  festooned  with  the  long 
Spanish  moss,  Tillandsia  umeoides. 

It  is  to  be  regretted,  however,  that  Dr.  Satch- 
well  did  not  inform  us  what  that  combination  of 
causes  was,  which  produced  the  particular  form  of 
malaria  experienced  at  this  fort.  Was  ik  other  than 
the  combined  action  of  heat,  moisture,  and  vegetable 
decomposition  ? If  so,  what  was  it  ? The  miasrna- 
tists,  it  will  be  remembered,  contend  that  all  three  ot 
these  elements  are  absolutely  necessary  for  the  pro- 
duction of  febrific  miasmata  ; and  yet,  in  this  partic- 
ular instance,  at  least,  it  is  admitted  that  “ in  general 
terms  there  was  no  decaying  vegetable  matter  about 
the  place,”  for  Dr.  Satchwell  durst  not  infer  the  ex- 
istence of  miasmata  from  the  offensive  putrefaction 
of  mushrooms,  since  he  clearly  maintains,  when  speak- 
ing of  the  Roanoke  country,  that  the  offensive  decay 
of  vegetable  matter  does  not  produce  disease.  It  is 
equally  to  be  regretted,  that  he  did  not  tell  us  what 
particular  form  of  malaria  was  present  at  this  locality. 
Was  it  different  from  that  form  which  produces  ague 
and  fever,  bilious  fever,  and  yellow  fever?  If  so, 
what  constituted  the  difference?  Was  it  owing  to 
the  fact  that  “in  general  terms  there  was  no  decay- 
ing vegetable  matter  about  the  place,”  and  therefore 
no  exhalation  from  vegetable  decomposition  could  en- 
ter into  its  character  and  nature  ? Or,  after  all,  does 


ADDEESS  ON  MALAEIA. 


93 


Dr.  Satchwell  believe  in  different  forms  of  malaria  as 
“necessary”  for  the  production  of  the  different  forms 
of  periodical  fevers ; and  that,  at  least,  one  of  the  most 
deadly  of  these  forms  may  be  produced  in  a situation 
where  “there  was  no  decaying  vegetable  matter  about 
the  place.”  If  he  does,  then  he  virtually  surrenders 
the  question,  and  the  abstract  idea  of  a specific  pois- 
on, one  and  indivisible,  which  exhales  from  decom- 
posing vegetable  matter,  and  produces  periodical  dis- 
eases, becomes  a mere  figment  of  the  brain. 

Now,  the  truth  of  the  whole  matter  is  simply 
this  : Fort  Macomb  is  an  excessively  damp  place,  and 
ill-suited,  therefore,  to  the  purposes  of  a fort  or  dwel- 
ling. Dr.  Holmes  says : “ This  locality  being  the 
principal  one  in  the  neighborhood,  covered  a space  of 
about  two  hundred  square  yards.”  It  had  a stratum 
of  stiff  white  clay  underlying  most  of  it  “ at  vary- 
ing depths  of  from  one  to  several  feet,”  and  that 
you  might  trace  it  (the  clay)  with  almost  unerring 
“ certainty  by  the  nature  of  the  dead  and  living  veg. 
etables  on  the  sand  above  it.”  “ Heavy  branches  and 
trunks  of  pines  and  oaks,  would  be  moist  and  wet  in 
the  dry  months  of  winter,  in  Florida,  Avhile  a profuse 
growth  of  ephemeral  mushrooms,  such  as  spring  up 
in  the  North  only  after  heavy  rains,  would  meet  the 
eye  at  every  step,  even  when  rain  had  not  fallen  for 
several  weeks dotting  with  their  pure  Ver- 

million color  nearly  every  inch  of  ground  in  the  local- 
ity.” This  description  answers  very  well  for  many 


94 


ADDRESS  ON  MALARIA. 


places  in  the  unhealthy  portions  of  North  Carolina, 
and  will  no  doubt  be  recognized  for  an  old  and  fa- 
miliar acquaintance,  excepting  the  mushrooms,  by 
some  of  the  medical  gentlemen  present. 

This  same  writer,  Dr.  Holmes,  whom  Dr.  Satch- 
well  accounts  very  learned  and  very  reliable,  says : 

“ The  want  of  rain,  and  consequently  of  moisture  in 
the  earth,  will  forever  relieve  the  Mexicans  from  the 
curse  of  malarial  diseases.” 

How  widely  different  is  the  experience  of  Dr 
Porter,  who,  as  surgeon  of  the  army,  accompanied  the 
regular  troops,  from  Corpus  Christi,  along  the  line  of 
operations  on  the  Rio  Grande  to  Sattillo,  and  after- 
wards from  Vera  Cruz  to  the  city  of  Mexico.  He 
informs  us,  in  his  “ Medical  and  Surgical  notes  of  the 
Campaigns  in  the  war  with  Mexico,”  that  “ the  men 
were  hale  and  hearty  after  the  severe  winter  at  Cor- 
pus Christi ; for  the  invalid  and  worthless  portion  of 
the  troops  had  been  left  behind :”  but  that  intermit- 
tents  and  remittents  were  rife  in  and  about  Monterey 
before  and  after  the  capitulation  of  that  place,  not- 
withstanding it  has  “ an  elevation  of  njpre  than  4000 
feet  above  the  level  of  the  sea.” 

“ The  inhabitants  of  the  town,”  he  says : “ have 
suffered  severely  from  fevers,  as  well  as  our  troops  ; 
from  the  hospital  at  the  Casa  Arista  to  the  Plaza  de 
la  Capella,  Carnpo  Santo,  or  ‘ Cemetery,1  a distance 
of  half  a mile,  whole  families  have  been  sick  with  in- 
terinittents  and  remittents.” 


ADDEESS  ON  MALAKIA. 


95 


He  farther  says  : “ In  the  city  of  Mexico,  eleva- 
ted, according  to  Humholt,  7,469  feet  above  the  level 
of  the  sea,  all  the  causes  of  disease  which  were  in  ac- 
tion at  Monterey,  operated  in  a still  greater  degree, 
and  the  wounded,  it  is  well  known,  recovered  bad- 
ly.”   

“ These  causes  of  disease,  variable  temperature 
of  the  day  and  night  in  autumn,  the  development  of 
malaria , the  fatigue  and  exposure  of  the  troops,  im- 
perfect Inematosis,  and  the  suppression  or  rapid  eva- 
poration of  the  perspiration,  appear  sufficient  to  ac- 
count for  the  mortality  among  our  troops  in  the  valley 
of  Mexico,  from  wounds,,  fever,  and  dysentery.” 

And  so,  Dr.  Black,  a very  clever  writer  on  the 
causes  of  malaria,  in  the  New  York  Journal  of  Med- 
icine, after  residing  for  some  time  in  California,  in- 
forms us  that  nine-tenths  of  the  diseases  in  that  sickly 
country  “are  unequivocally  of  malarious  origin,”  not- 
withstanding the  fact  that,  “from  April  to  Novem- 
ber there  is  a complete  deprivation  of  appreciable 
moisture — no  rain,  no  dew,  or  fogs.” 

Such  are  the  authorities  and  statements  brought 
forward  to  prove  the  miasmatic  origin  of  periodical 
fevers  on  the  hills  and  mountain  ridges,  and  other 
places  spoken  of  in  my  address,  where  “water  is  scarce, 
and  there  is  nothing  like  a marsh,”  and  which  Dr. 
Satchwell  sanctions  and  approves  of  in  the  following 
language : “ Many  situations  in  our  own  State  and 
country  that  are  counterparts  to  such  places  as  have 


96 


ADDRESS  OK  MALARIA. 


been  thus  described,  and  where  malarious  fevers  pre- 
vail, are  often  brought  forward  as  stumbling  blocks 
against  the  old  malarious  theory  of  Lancisi,  but,  as  it 
appears,  on  insufficient  grounds.” 

But,  notwithstanding  Dr.  Satchwell’s  endorse- 
ment of  these  different  and  contradictory  methods  of 
solving  this  difficulty,  he  surely  does  not  believe  in 
their  entire  truth ; for,  in  accounting  for  the  prevalence 
of  these  fevers,  during  the  years  1846,  ’47,  ’48,  in  the 
hilly,  mountainous,  and  hitherto  salubrious  portions 
of  North  Carolina,  he  endeavors  to  prove  their  mias- 
matic origin  in  a manner  the  reverse  of  all  this.  Then, 
it  suits  him  to  have  an  overland,  instead  of  an  under- 
ground theory,  and  to  declare  that  the  malaria  which 
is  sometimes  found  on  high  and  dry  ridges  has  been 
attracted  to  them,  and  falls  in  the  night  time,  after 
its  dispersion  in  the  air  during  the  day ; or  is  carried 
thither  by  the  winds.  “ In  this  way,”  he  says,  “ mal- 
arious fevers  occur  on  ridges  and  hills  frequently ; but 
it  is  equally  true,  that  such  high  places  and  hills  as 
have  not  wet  ground  at  their  base  are  remarkably 
salubrious.” 

Thus,  Dr.  Satchwell  himself  furnishes  us  sepa- 
rate, distinct  and  contradictory  modes  of  accounting 
for  the  origin,  from  marsh  poison,  of  those  periodical 
fevers  which  prevail  where  “ water  is  scarce,  and  there 
is  nothing  like  a marsh ;”  whilst  his  attempted  explan- 
ation with  regard  to  the  pregnant  example  furnished 
by  the  exploring  expedition,  as  referred  to  in  my  ad- 


ADDRESS  ON  MALARIA. 


97 


dress,  of  tlie  imsouudness  of  the  miasmatic  theory,  is 
worse  than  useless.  It  does  not  meet  the  case  at  all. 
It  was  only  that  portion  of  the  expedition,  which  was 
detailed  for  land  service,  after  reaching  Oregon,  that 
was  sickly  at  the  encampment  on  the  Wallamette. 
The  remaining  portion,  which  had  been  equally  as 
much  exposed  in  the  travels  and  duties  amongst  the 
Friendly,  Society,  Fegee,  Samoan,  and  Sandwich 
Islands,  escaped  the  disease  entirely.  It  could  not, 
therefore,  be  owing  to  the  exposure  to  miasmata  in 
these  islands,  which  rendered  the  encampment  on  the 
Wallamette  a sickly  one. 

Dr.  Satckwell  is  equally  unfortunate,  I think,  in 
impressing  his  readers  with  the  belief,  that  the  prev- 
alence of  periodical  fevers  “throughout  Raleigh  and 
vicinity,”  in  the  years  184(3,  ’47,.  and  ’48,  was  owing 
to  the  emanation  from  mill-ponds  in  the  neighborhood. 
The  mill-ponds  which,  “according  to  the  opinions  cf 
the  Raleigh  Physicians,  of  that  day,”  produced  the 
fevers  in  1822,  ’27,  and  ’28,  had  been  destroyed  for 
more  than  twenty  years,  and  none  others  had  been 
erected  ; yet  Raleigh,  and  the  whole  surrounding  coun- 
try, including  places  where  the  disease  had  hitherto 
never  made  its  appearance,  was  more  sickly  than  at 
any  former  period,  even  in  the  days  of  the  mill-ponds. 

But  I shall  now  leave  these  learned  doctors  to 
settle  their  own  differences — non  nostrum  tantas  com- 
ponere  lites — and  proceed  to  the  consideration  of  the 
second  division  of  my  subject,  wherein  I propose  ta> 


98 


ADDEESS  ON  MALAEIA. 


show  that  Dr.  Satchwell  entirely  fails  to  establish  the 
sanitary  properties  of  salt  mixing  with  fresh  water. 

Upon  this  question  Dr.  Satchwell  says:  “We 
incline  to  the  opinions  of  Dr.  Robert  Jackson  ; Dr. 
Dickson,  of  Charleston ; Dr.  James  Johnson,  an  En- 
glish author  of  great  observation  ; Dr.  Drake,  the 
Nestor  of  the  profession  in  the  West,  and  many  other 
medical  luminaries  in  the  old  and  new  world,  that  it 
■does  possess  sanitary  properties.”  With  equal  propri- 
ety, and  more  show  and  force  of  reason,  he  might  have 
yielded  his  assent  to  the  opinions  and  views  of  Pro- 
fessor Wood,  of  the  University  of  Pennsylvania ; Pro- 
fessor Dunglison,  of  the  Jefferson  Medical  College ; 
Dr.  Eberle,  one  of  the  early  medical  writers  of  this 
-country ; Sir  John  Pringle,  “ an  English  author  of 
great  observation”  and  experience ; Dr.  Joseph  Brown, 
dhe  celebrated  author  of  the  very  popular  article, 
Malaria,”  in  the  Cyclopedia  of  Practical  Medicine, 
who  says,  “ marshes,  whether  salt  or  fresh,  are  prolific 
sources  of  malaria ;”  Monfalcon,  who  gives  a number 
of  instances  to  prove  the  insalubrity  of  a mixture  of 
salt  and  fresh  water,  of  which  the  following  are  in- 
teresting examples  : In  the  South  of  France  there  are 
two  pools,  Valdec  and  Eugrenier,  very  near  each 
other,  being  separated  only  a few  rods.  The  former 
is  very  salt,  while  the  latter  is  quite  fresh.  But  when- 
ever these  pools  rise  and  run  together,  as  they  do 
sometimes,  the  adjoining  localities  immediately  be- 
come very  sickly,  which  is  not  the  case  at  other  times. 


ADDRESS  ON  MALARIA. 


99 


And  also,  that  there  is,  to  the  South  of  the  Ligurian 
Appenines,  near  Lukes,  a very  large  marshy  plain, 
accessible  to  the  high  tides  of  the  ocean,  which  ren- 
dered the  neighboring  country  almost  uninhabitable, 
until  the  salt  water  of  the  sea  was  shut  off  from  the 
fresh  water  of  the  marsh,  when,  as  in  the  case  of 
Viareggio,  it  became  very  healthy,  and  the  popula- 
tion increased  rapidly.  Fodere,  treating  of  this  sub- 
ject, affirms  that  the  vicinity  of  large  lakes,  rivers,  or 
the  sea,  is  ordinarily  healthy,  “ unless  there  is  an  ad- 
mixture of  salt  and  fresh  water and  such  too,  is  the 
opinion  of  Fourcault,  Marchetti,  and  a host  of  “ other 
medical  luminaries  in  the  new  and  old  world.”  Even 
Lancisi  assures  us  that  “ the  air  is  dreadful  in  low  pla- 
ces, near  the  sea-shore,  into  which  the  waves  find  en- 
trance by  a canal  that  has  either  been  open  during 
the  memory  of  man,  or  made  by  human  contrivance, 
or  produced  by  a storm  ; and  into  which  receptacle 
also,  the  rains  wash  down  the  filth  from  the  adjacent 
hills  and  knolls.” 

Indeed  there  is  not  a shadow  of  doubt,  but  that 
numbers,  and  the  weight  of  authority,  would  decide 
that  salt  mixing  with  fresh  water  does  not  possess 
sanitary  properties.  But  this  is  not  the  proper  me- 
thod, of  settling  any  important  question.  Try  it  ra- 
ther by  the  rules  of  just  argument,  and  common 
sense — by  the  instantia  crucis,  if  you  will — and  see 
where  the  truth  lies.  Accordingly,  I shall  subject  it 
to  this  criterion ; but  before  doing  so,  I will  make 


100 


ADDRESS  ON  MALARIA. 


the  subjoined  extract  from  Dr.  James  Johnson’s  work 
on  Tropical  Climates,  for  the  purpose  of  showing  how 
little  weight  his  authority  should  have  in  this  matter. 
Speaking  of  bilious  fever,  which  Dr.  Satchwell,  I 
dare  say,  believes  is  owing  to  marsh  poison,  and 
therefore  cannot  occur  under  the  sanitary  influence 
of  salt  water,  Dr.  Johnson  says:  “This  is  the  grand 
endemic  or  rather  epidemic  ( morbus  rejionalis)  of  hot 
climates,  and  although  greatly  allied  in  many  of  its 
symptoms,  perhaps  generally  combined  with  the 
marsh  remittent  already  described,  yet  it  occurs  in  va- 
rious places,  both  at  sea  and  on  shore,  where  paludal 
effluvia  cannot  be  suspected.”  Now,  this,  extract,  un- 
der any  point  of  view,  contains  much  that  should  be 
highly  interesting  to  the  miasmatists,  and  I therefore 
take  great  pleasure  in  commending  it  to  their  especi- 
al consideration,  notwithstanding  I have  brought  it 
forward  in  this  particular  connection,  to  show  that 
bilious  fever  may  occur  at  sea,  “ where  paludal  effluvia 
cannot  be  suspected,”  and  despite  the  supposed  sani- 
tary influence  of  salt  water. 

But  let  us  proceed  with  our  instances,  and  in- 
quire why  it  is  that  Galveston  Island,  a mere  bed  of 
drifted  sand,  scarcely  elevated  above  the  Gulf,  and 
subject  to  inundations  from  its  waves  during  the  prev- 
alence of  Southern  and  Eastern  winds,  slionld  be  so 
much  more  sickly  than  the  Island  of  Grand  Terre, 
situated  at  the  mouth  of  Bayou  La  Fourche,  with  a 
productive  soil,  and  elevated  several  feet  above  the 


ADDRESS  ON  MALARIA. 


101 


highest  tides  of  the  Gulf?  Or  why  the  head  of  Pen- 
sacola Bay,  where  the  Escambia  Biver  empties,  and 
where  they  have  sea  breezes  and  brackish  waters  ; or 
the  shores  at  the  mouth  of  Mobile  River,  and  around 
Mobile  Bay,  where  the  waters  are  quite  salt,  should 
be  more  sickly  than  the  Balize  ? The  Island  of  Key 
"West,  which  is  a portion  of  the  Florida  Reef,  with  a 
slight  soil,  supporting  a scanty]  growth  of  herbaceous 
vegetation,  small  trees,  and  shrubs,  had,  several  years 
ago,  ditches  and  small  canals  cut  through  it  by  Com- 
mander McIntosh,  to  allow  the  tides  of  the  Gulf  to 
flow  into  the  marshes,  and  the  fresh  water  of  the 
great  rains  to  flow  out  of  them ; yet  this  situation  is 
much  more  sickly  than  the  rice  lands  of  Louisiana, 
which  are  not  overflowed  by  the  Gulf  waves,  but 
which  Dr.  Randall  states  are  not  unhealthy,  though 
cultivated  by  white  men.  And  so  I might  inquire 
why  the  Mississippi  and  Amazonic  Deltas  are  so  much 
more  healthy  than  those  of  the  Niger  and  Ganges  ? 
Or  those  of  the  Scheldt  and  Rhine,  and  Po,  so  much 
more  sickly  than  the  Nilous  Delta?  Or  how  it  is, 
that  British  Guiana  has  been  rendered,  by  the  diking 
out  of  the  salt  waters,  “capable  of  being  healthfully 
tenanted  by  European  residents,”  notwithstanding 
“ its  wide  alluvial  tracts.” 

Thus  I might  go  on  multiplying  authorities  and 
instances  to  prove  that  salt  mixing  with  fresh  water 
does  not  “possess  sanitary  properties;”  but  I prefer 
to  give  this  question,  so  far  as  Dr.  Satchwell  is  con- 


102 


ADDRESS  ON  MALARIA. 


cerned,  tlie  coup  dc  grace , by  showing  that  the  main 
facts  which  he  relied  upon  to  establish  his  position, 
have,  in  the  regular  course  of  events,  been  turned 
against  him,  demonstrating  with  what  imprudent 
haste  he  has  jumped  to  unwarranted  conclusions.  It 
was  this  “ loose  and  too  hasty  system  of  generaliza- 
tion, attempting  to  define  the  complex  before  the  sim- 
ple is  faithfully  learned,”  which  I have  elsewhere  sta- 
ted, “has  led  medical  minds, loaded  with  hypotheses, 
into  endless  vagaries  and  absurdities  in  their  specula- 
tions upon  the  subjects  of  practical  etiology.” 

“Some  four  or  five  years  ago,”  says  Dr.  Sateh- 
well,  “ a new  inlet  broke  in  from  the  ocean  into 
Pamlico  Sound  during  a severe  storm.  Since  then 
the  waters  of  the  Pamlico  and  its  tributaries  have 
been  much  more  salt  than  ever  before;  and  since  then 
the  whole  Pamlico  region,  where  salt  water  extends, 
has  been  more  than  ordinarily  exempt  from  malari- 
ous fevers  ?”  “ It  has  been  unusually  healthy  in  the 

Pamlico  region,  where  there  is  salt  water,  since  this 
new  formation  of  nature.”  “ Places  in  the  vicinity, 
and  on  the  sound,  and  river,  and  branches,  have  been 
unusually  free  from  fall  sickness  within  this  period, 
that  were  sickly  before,  and  under  those  circum- 
stances of  season,  too,  that  formerly  attended  sick- 
ness.” 

The  essay,  from  which  the  above  extracts  were 
taken,  was  delivered  in  the  early  part  of  May,  1852, 
after  several  years  of  unwonted  health  in  all  the  Eastr 


ADDRESS  ON  MALARIA. 


103 


era.  or  paludal  portions  of  North  Carolina,  and 
after  the  opening,  some  years  before,  of  a new  in- 
let into  Pamlico  Sound,  which  rendered  the  inland 
waters,  for  a considerable  distance  from  the  ocean, 
quite  saltish. 

So  far,  so  good.  Here  is  a concurrence  of  events, 
and  if  the  healthiness  of  these  portions  of  North  .Ca- 
rolina had  certainly  and  immediately  followed  upon 
the  opening  of  this  new  inlet,  as  stated  by  Dr.  Sateh- 
well,  and  remained  so,  and  that  too,  after  the  same 
district  of  country  had  been  as  certainly  rendered  in- 
salubrious by  the  closing  of  the  old  inlets,  then  we 
should  have  had  something  like  what  a cause  and  its 
effects  should  be  to  challenge  our  admiration  and  res- 
pect. But,  in  reality,  how  does  the  matter  stand  ? — 
Did  the  unusual  amount  of  health  enjoyed  by  these 
sections  of  our  State,  immediately  and  certainly  follow 
upon  the  bursting  open  of  this  inlet  ? It  certainly 
did  not ; but  rather  preceded  it.  This  cyrcle  of  com- 
paratively healthy  years  began  before  the  inlet  was 
opened,  and  terminated  whilst  it  was  still  as  open  as 
it  had  ever  been,  thus  showing  that  there  was  no  con- 
nection of  cause  and  effect  in  this  instance,  but  only 
a coincidence.  This  cycle  of  healthy  years  began  in 
1815,  a year  or  two  before  the  inlet  was  opened,  and 
terminated  with  the  summer  and  autumn  of  1851, 
just  prior  to  the  delivery  of  Dr.  Satch well’s  essay  on 
malaria.  But  he  did  not  know  this  fact.  How  could 
he  know  it?  The  sickly  season  of  the  year  1852,, 


104 


ADDRESS  OIST  MALARIA. 


had  not  yet  come  on ; and,  of  course,  tlie  inlet  being 
still  open,  and  the  waters  brackish,  he  would  not  'as- 
pect it.  Had  he  postponed  the  publication  of  his 
views  until  the  autumn  following,  when  the  whole  of 
the  Pamlico  country  was  remarkably  sickly,  notwith- 
standing this  new  inlet  Avas  more  open,  and  the  in- 
land waters  more  brackidi  than  for  years  before,  he 
would  have  had  an  excellent  opportunity  to  review 
his  opinions  upon  this  subject,  a little  matter  of  trou- 
ble which  no  real  philosopher  ever  shrinks  from,  but 
rejoices  at,  as  it  justly  affords  him  the  occasion  of 
another  effort  to  investigate  truth,  after  having  satis- 
factorily demonstrated  a false  fact.  The  truth  is,  the 
years  1852  and  1853,  Avere  \Tery  sickly  years,  even  for 
that  sickly  country,  notwithstanding  this  new  inlet 
was  as  open  as  ever,  and  the  inland  Avaters  more  brack- 
ish than  before. 

In  Edenton  Bay,  and  in  the  mouth  of  Chowan 
River,  at  the  head  of  Albemarle  Sound,  the  waters 
were  quite  brackish,  and  crabs  and  salt-water  fish, 
which  had  not  been  knoAvn  there  before  for  twenty 
years  or  more,  became  quite  plenty.  And  at  Hert- 
ford, on  the  Perquimons  River,  a steam  mill  found  it 
impossible  to  use,  with  convenience  and  advantage, 
the  river  water,  Avhich  had  always  been  done  before, 
on  account  of  the  incrustations  of  salt  in  the  boilers; 
yet  these  situations,  aud  all  the  adjoining  country,  on 
both  sides  of  the  sound,  and  on  its  tributaries,  were 
more  sickly  than  they  had  been  known  to  be  for  a 


ADDRESS  ON  MALARIA. 


105 


great  many  years.  Even  in  the  Fairfield  and  Mat  ta- 
muskeet  country,  where,  according  to  Dr.  Satchwell, 
“the  farmers  have  made  model  farms  in  as  rich  and 
fine  a country  as  the  sun  of  heaven  ever  shone  upon,’’ 
periodic  levers  have  prevailed  for  the  last  two  years, 
notwithstanding,  in  his  judgment,  “ drainage  and  long 
cultivation  have  removed  that  moisture  and  vegetable 
decomposition  essential  to  the  generation  and  extrica- 
tion of  malarial'1  from  the  soil. 

But  instances  of  healthy  and  unhealthy  years  or 
seasons,  in  paludal  districts  of  country,  recurring  even 
at  somewhat  regular  or  stated  periods  of  time,  have 
frequently  been  observed  and  spoken  of  by  different 
writers  on  periodic  fevers ; while  the  circumstances 
of  those  regions,  so  far  as  relates  to  the  production  of 
miasmata,  by  the  decomposition  of  vegetable  matter 
by  heat  and  moislure,  remained  the  same.  Such 
facts  are  not  only  remarkable,  but  they  cannot  be 
explained  by  the  popular  doctrine  of  a specific  mi- 
asm, which  emanates  from  the  decomposition  of  veg- 
etable matter. 

I come  now  to  the  third  division  of  my  subject,  in 
which  I mean  to  show  that  Dr.  Satchwell’s  state- 
ments are  incorrect  with  regard  to  the  Roanoke  coun- 
try, and  some  of  the  swamp  lands  of  our  State. 

lie  thinks  my.  difficulty  natural  enough  with  one 
“ unacquainted  with  the  true  condition  of  that  region” 
in  1850.  Now  it  so  happens  that  I am  not  only  very 
well  acquainted  with  that  region  of  country  general- 


106 


ADDRESS  ON  MALARIA. 


ly,  haviug  practiced  through  it,  on  both  sides  of  the 
river,  for  several  years,  but  that  I informed  myself 
thoroughly  with  regard  to  its  circumstances  and  con- 
dition before  and  after  the  great  fresh  of  1850,  previ- 
ous to  writing  a word  upon  the  subject,  in  my  ad- 
dress of  1851.  Dr.  Satchwell  is  mistaken  in  sup- 
posing the  spring  and  early  summer  of  1850,  upon  the 
Roanoke,  were  unusually  dry.  They  were  unusually 
wet ; and  this  statement  is  confirmed,  not  only  by  the 
recollection  of  the  planters  on  the  river,  but  it  is  es- 
tablished, made  a fixed  fact,  beyond  all  doubt  or  con- 
tradiction, by  the  farming  journal  of  Mr.  John  Dev- 
ereux,  an  intelligent  gentleman  and  planter  on  the 
lower  Roanoke,  who  keeps  a daily  record  of  the 
weather,  seasons,  and  work  done  upon  his  plantation. 

From  this  source,  the  most  reliable  of  all  others, 
I am  furnished  wilh  the  indisputable  proof,  that  the 
spring  and  early  summer  of  1850  were  wet  seasons  ; 
and  that  the  drought,  which  became  intense  during 
the  months  of  July  and  August,  did  not  set  in  until 
the  latter  part  of  June.  Mr.  Devereux  was  not  able 
to  get  all  his  land  in  order  for  the  planting  of  corn 
until  after  the  first  week  in  June,  on  account  of  the 
rains  and  incessant  wet.  Others  were  similarly  situ- 
ated ; and  these  facts,  recorded  four  years  ago,  on  the 
da}7s  of  their  occurrence,  by  Mr.  Devereux,  who  lives 
in  the  immediate  neighborhood  of  other  large  plan- 
ters, whose  statements  are  corroborated  by  his  jour- 


ADDRESS  ON  MALARIA. 


107 

nal,  show  that  the  very  circumstances,  viz:  a wet 
spring  and  early  summer,  succeeded  by  a drought, 
which  the  miasmatists  claim  as  best  calculated  to 
produce  febrific  exhalations,  existed  in  this  instance, 
and  yet  there  was  comparative  exemption  from  dis- 
ease. 

Moreover,  Mr.  Devereux  lives  in  the  neighbor- 
hood of  the  most  extensive  region  of  flats  and  bottoms 
that  are  to  be  found  upon  the  Roanoke.  They  are 
known  as  the  marshes,  par  excellence;  and  it  is  fur- 
ther known,  that  some  of  these  did  not  dry  up  entire- 
ly until  August — if  then. 

Dr.  Satchwell  is  also  mistaken  in  asserting  that, 
after  the  embankments  on  the  river  gave  way,  in  the 
latter  part  of  August  of  that  year,  the  flood  of  “ wat- 
ers rushed  with  irresistible  rapidity  to  the  ocean,  re- 
maining but  a few  days  on  the  low  grounds.”  So  far 
from  this  being  the  case,  the  bottom  lands  and  swamps 
remained  covered  with  water  for  a considerable  time ; 
and  some  of  the  ponds,  which  had  been  filled  with 
water  at  the  flood,  being  incapable  of  emptying  them- 
selves regularly  and  “ rapidly1'1  along  with  the  reced- 
ing waters  of  the  liver,  retained  most  of  it,  and  exhibi- 
ted its  visible  effects  until  the  last  of  November,  or 
until  the  rains  of  winter  set  in.  Indeed,  just  such  a 
state  of  things  existed  in  this  instance,  with  regard  to 
the  filling  up  of  the  swamps,  and  bottoms,  and  ponds 
with  the  overflowing  water;?  of  the  river,  as  is  describ- 
ed by  Dr.  Satchwell,  from  Dr.  Jas.  Johnson’s  work 


108 


ADDRESS  01V  MALARIA. 


on  Tropical  Climates,  for  the  Ganges.  “Overflow- 
ing,” lie  says,  “ the  banks  as  it  does,  and  filling  the 
pools  and  bottoms  at  some  distance  back,  the  water 
stagnates.  The  vegetable  matter  is  thus  acted  on  for 
weeks,  under  the  most  favorable  decomposing  circum- 
stances.” 

But  the  overflowing  of  -the  banks  of  rivers, 
lakes  or  other  collections  of  fresh  or  salt  water,  during 
hot  weather,  particularly  after  the  receding  waters 
have  fallen  within  their  natural  limits,  or  bounds,  has 
always,  and  everywhere,  from  the  da)  s of  Lancisi  to 
the  present,  time,  been  considered  by  the  miasmatists 
to  be  a fruitful  source  of  febrific  exhalations.  Thus 
Copland,  in  his  Dictionary  of  Practical  Medicine,  arti- 
cle Endemic  Influences,  says:  “Inundations,  whether 
from  the  sea  or  the  swelling  of  rivers,  or  from  an  ad- 
mixture  of  sea  with  river  water,  render  low  grounds 
particularly  insalubrious  upon  their  being  exposed  to 
the  action  of  the  sun’s  rays.” 

As  to  the  sickness  which  occurred  on  Mr.  Jame3 
C.  Johnston’s  plantation  on  the  Roanoke,  it  may  be 
remarked  that  the  simple  circumstance  of  his  letting 
the  water  into  his  mill  pond  from  the  river,  and  the 
subsequent  exhaustion  of  it  during  the  early  part  of 
November,  could  not  be  the  cause  of  disease.  This 
pond  gets  empty  nearly  every  year  during  the  latter 
part  of  summer,  and  under  the  drying  process,  ac- 
cording to  the  best  accredited  views  of  the  miasmat- 
ists,  furnishes  an  abundance  of  material  for  febrific 


ADDRESS  ON  MALARIA. 


109 


exhalations,  because  the  muddy  bottom  and  “vegeta- 
ble matter  is  thus  acted  on  for  weeks,  under  the  most 
favorable  decomposing  circumstances yet  it  has 
never  been  the  cause  of  disease  on  this  plantation, 
nor  does  Mr.  Johnston,  than  whom  there  is  no  more 
capable  judge,  believe  it  was  the  cause  of  sickness 
this  year.  He  says  the  plantation  every  year,  from 
the  circumstance  of  the  swamps  and  ponds  drying 
up  in  the  summer,  affords  more  sources  for  emana- 
tions from  decomposing  vegetable  matter,  than  it  did 
this  year,  yet  it  is  one  of  the  healthiest  plantations 
on  the  river. 

Besides,  the  sickness  which  prevailed  at  this  place 
was  typhoid  fever,  which  commenced  in  the  very  last 
of  October,  or  early  in  November,  and  extended 
through  the  winter , becoming  typhoid  pneumonia,  as 
is  usually  the  case  with  that  disease,  whenever  it 
assails  a plantation  of  negroes  on  the  Roanoke,  late  in 
autumn,  when  bilious  fevers  generally  have  ceased 
to  manifest  themselves,  and  runs  into  the  winter 
months.  These  facts  are  abundantly  proven,  not  only 
by  my  own  experience,  but  by  the  experience  of  eve- 
ry medical  gentleman  “ familiar  ” with  these  locali- 
ties, and  with  the  typhoid  fevers,  which  sometimes 
assail,  in  a most  unaccountable  manner,  the  negro 
population  on  some  one  or  two  of  the  large  planta- 
tions on  the  Roanoke,  while  other  places,  apparently 
no  better,  if  so  well  protected  against  zymotic  influ- 
ences, escape  entirely. 


110 


ADDRESS  ON  MALARIA. 


Whilst  upon  the  subject  of  the  Roanoke  bottoms, 
I will  mention  the  fact  that  many  of  these  swamps 
have  been  extensively  worked  by  timber  and  shingle 
getters.  The  timber  is  mostly  cypress,  not  juniper, 
and  has  been  gotten  up  into  shingles,  or  logs,  in  which 
latter  shape  it  is  floated  to  the  saw  mills  to  be  cut 
into  lumber.  By  these  means  the  swamps  have  been 
greatly  thinned  of  their  heavy  growth,  and  that  foli- 
age which  protected  the  soil  from  the  sun’s  rays. — 
Many  of  these  timber  swamps  are  connected  with 
the  adjoining  plantations,  being  owned  by  persons 
who  farm  upon  the  higher  grounds  and  reclaimed 
bottoms,  while  they  work  up  the  timber  of  the  swamps 
and  marshes.  I have  practised  among  these  planta- 
tions, but  my  patients  were  furnished  from  the  farms, 
and  not  from  the  swamps,  notwithstanding  the  swamp 
hands  were  in  the  habit  of  coming  out  of  the  swamps 
on  Saturday  evening,  and  remaining  at  the  quarters 
of  the  plantation  negroes  with  their  wives  and  fami- 
lies until  Monday  morning;  and  notwithstanding,  fur- 
ther, the  swamps  are  sufficiently  cleared  up,  in  many 
instances,  and  dry  enough  too,  in  the  latter  part  of 
summer,  and  in  autumn,  during  the  bilious  fever  sea- 
son, to  have  cart  ways  through  them,  even  to  the 
bank  of  the  river.  What  I have  here  stated  with  re- 
gard to  the  Roanoke  Swamps  and  bottoms,  is  not 
only  strictly  true  of  them,  as  may  be  established  by 
a mass  of  ii  refragable  testimony,  but  it  is  likewise  true 
of  many  other  portions  of  the  swampy  districts  of 


ADDRESS  ON  MALARIA. 


Ill 


Eastern  North  Carolina.  Thus,  Mr.  James  McDon- 
ald, who  had  charge  of  the  fifty  or  sixty  laborers 
who  were  engaged,  daring  the  summer  of  1853,  in 
constructing  that  portion  of  the  Wilmington  and 
Manchester  railroad,  which  crosses  Eagles  Eland,  op- 
posite to  Wilmington,  informs  me  that  they  were  re- 
markably healthy,  no  one  of  them  losing  more  than 
two  or  three  days,  during  the  entire  period  they  were 
engaged  in  this  work.  The  line  of  road,  he  says, 
was  sixty  feet  wide,  and  passed  along  cypress  swamps 
and  old  neglected  rice  fields  with  a deep  alluvial  soil, 
over  which  heavy  fogs  would  settle  every  night,  com- 
pletely drenching  the  clothes  of  the  workmen,  most 
of  whom  would  go  out  and  sleep  upon  the  cross  ties 
of  the  road,  so  that  in  the  morning,  when  called  up, 
their  clothes  would  be  as  wet  as  though  they  had  been 
in  the  rain.  In  this  condition,  these  men,  who  were 
mostly  foreigners,  and  wrho  vrere  spending  their  first 
summer  at  the  south,  would  begin  their  work,  and 
prosecute  it  through  the  long  summer  days,  under 
the  sickening  influence  of  a southern  sun,  and  yet 
there  was  not  a single  case  of  ague  and  fever  among 
them. 

Dr.  Satchwell  thinks  the  escape  of  the  workmen 
from  sickness,  while  engaged  in  ditching  and  canaling 
our  public  lands,  was  owing  to  the  great  amount  of 
water  in  the  soil,  before  the  “ canals  were  completed 
from  Pungo  and  Alligator  Lakes  to  their  outlets  in 
Pungo  river  and  Rutman’s  creek.”  Now,  this  cannot 


112 


ADDRESS  ON  MALARIA. 


be,  for  two  very  simple  but  very  obvious  reasons. — 
In  the  first  place,  it  is  notoriously  true  that  some  of 
these  lands,  before  these  ditches  and  canals  were  be- 
gun, and  certainly  during  the  period  in  which  the 
work  was  prosecuted,  would  become  so  exceedingly 
dry  as  to  take  fire  and  burn  up,  from  the  great 
amount  of  woody  matter,  and  even  logs  of  timber, 
which  were  underlying  the  soil.  These  fires  would 
generally  commence  with  the  burning  of  a stump, 
which  would  convey  the  destructive  element  below 
the  soil,  to  the  underlying  stratum  of  combustible 
materials,  in  such  a state  of  perfect  dryness  as  to  be 
readily  ignited.  In  the  second  place,  there  was  al- 
lowed sufficient  drainage  to  the  canals  and  ditches,  as 
they  were  cut,  to  prevent  the  accumulation  of  water 
in  them  to  such  extent  as  to  interrupt  the  progress  of 
the  work.  This  alone,  considering  the  great  tenden- 
cy to  extreme  dryness,  on  many  portions  of  these 
lands,  would  sufficiently  drain  them,  not  only  to  pre- 
vent the  water  from  springing  “ into  and  around 
your  boots  by  a very  moderate  pressure  on  the  spon- 
gy surface,  though  apparently  dry,”*  but  also  afford 
plentiful  exhalations  from  the  vegetable  matter  in 
the  soil,  under  the  drying  influence  of  the  hot  months 
of  summer  and  autumn,  after  it  had  been  previously 
soaked  in  water  during  the  entire  winter  and  spring. 
Besides,  the  immense  upturning  of  rich  earth,  neces- 
sarily effected  by  the  digging  of  these  canals,  which 


* Dr.  Satchwell. 


ADDRESS  ON  MALARIA. 


118 


had  never  been  previously  exposed  to  the  sun’s  raysT 
ought,  according  to  the  teachings  of  the  miasmatists, 
during  the  hot  months  of  summer  and  autumn,  to  be 
a fruitful  source  of  febrific  miasms.  Upon  this  sub- 
ject, Lind  says : “ The  effluvia  from  ground  newly 
opened,  whether  from  graves  or  ditches,  are  far  more 
dangerous  than  those  from  the  same  swampy  soil, 
where  the  surface  is  undisturbed.” 

I have  now  finished  my  remarks  in  reply  to  Dr. 
Satchwell’s  strictures  on  my  address,  delivered  here 
three  years  ago ; and,  although  I am  conscious  of 
having  trespassed  too  long  on  your  patience,  yet  I 
must  beg  your  indulgence  for  a few  moments,  while 
I sum  up,  in  as  brief  a manner  as  possible,  the  hete- 
rogeneous and  contradictory  opinions  which  have  pre- 
vailed with  some  of  the  highest  authorities  in  medicine, 
as  to  the  origin  of  periodical  fevers  and  the  laws  of 
marsh  miasms. 


SUPPOSED  ORIGIN  OF  PERIODICAL 
FEVERS. 


Lancisi,  in  1695,  ascrib- 
ed the  origin  of  periodi- 
cal fevers  to  marsh  miasm , 
which  he  affirmed,  consist- 
ed of  effluvia  of  inorganic 
and  animalcular  constitu- 
tion. 


Richter,  a distinguish- 
ed German  writer,  speaks, 
of  them  as  caused  by 
worms  and  other  sources 
of  intestinal  irritation  ; 
by  suppression  of  the  ca- 
tamenia, and  other  habi- 
tual discharges. 


8 


114 


ADDRESS  ON  MALARIA. 


Henry  Holland  and 
others  believe  that  these 
fevers  are  produced  by  a 
host  of  animalcules  which 
float  about  in  the  air. 

Elliotson  says  that  an 
exhalation  from  decaying 
vegetable  matter  is  the 
true  indispensable  and  ex- 
citing cause  of  ague  and 
fever. 

Annesly,  a writer  on 
the  diseases  of  British  In- 
dia, concludes  that  the 
cause  is  the  product  of 
the  different  elements 
which  are  found  in  rich 
soils,  when  acted  on  by 
heat,  the  air  and  mois- 
ture. 

Armstrong  rejects,  al- 
together, the  doctrine  of 
a specific  poison  in  ac- 
counting for  their  origin. 


J.  K.  Mitchell  thinks 
them  owing  to  the  injuri- 
ous and  poisonous  action 
of  the  sporules  of  fungi, 
which  are  disseminated 
through  the  air. 

Ferguson  denies  the  ne- 
cessity of  vegetable  decom- 
position to  produce  these 
diseases,  but  attributes 
them  to  the  rapid  evapo- 
ration of  water  in  an  arid 
soil. 

Dr.  Watson  declares 
that  the  primary  exciting 
cause  of  intermittent  and 
remittent  fevers,  without 
which  ague  would  never 
occur,  is  a specific  poison, 
producing  specific  effects 
on  the  human  body. 

Tolloch  thinks  there 
does  not  exist  any  relati- 
onship whatever,  as  cause 
and  effect,  between  marsh 
exhalations  and  ague  and 
fever. 


ADDRESS  OK  MALARIA. 


115 


Dr.  Wood  admits  that 
periodical  fevers  may  ori- 
ginate without  any  emula- 
tion from  vegetable  de- 
composition to  poison  the 
atmosphere. 

Dr.  Bell,  of  Philadel- 
phia, and  Prichett,  in  his 
account  of  the  African  re- 
mittent fever,  think  that 
the  known  and  apprecia- 
ble states  of  the  earth’s 
surface,  superincumbent 
atmosphere,  and  modes  of 
life,  will  account  for  the 
origin  of  these  fevers. 

Boussingault  has  recent- 
ly advocated  with  some 
zeal  the  theory  that  car- 
buretted  hydrogen  is  the 
active  morbific  agent  in 
the  production  of  periodic 
fevers.  He  detected  car- 
bon in  the  dew  of  marsh- 
es in  the  department  of 
Ain,  and  having  ascer- 
tained that  hydrogen  ex- 


Sir  James  Murray  con- 
tends that  the  true  mala- 
rious agents  are  electro- 
galvanic  currents  and  ac- 
cumulations. 

Professor  Daniells,  and 
the  Drs.  Gardner,  of  Lon- 
don, and  Hampden  Sid- 
ney College,  Virginia, 
think  that  the  active  a- 
gent  which  produces  fe- 
vers in  malarious  situati- 
ons is  the  sulphuretted  hy- 
drogen to  be  found  in  their 
waters. 

Dr.  Gardner  admits 
that  this  gas  is  undoubt- 
edly produced  wherever 
vegetable  matters  are  un- 
dergoing putrefaction  ; 
but  contends  that  “ those 
circumstances  which  auo- 

O 

ment  and  even  produce 
malaria,  (as  in  the  Liguri- 
an marshes  and  those  of 
South  Carolina,)  are  in  no 


116 


ADDRESS  ON  MALAEIA. 


istecl  in  the  same  situa- 
tions, he  concluded  that 
carbon  existed  there  as 
carburetted  hydrogen. 


Fordyce  in  his  discour- 
ses earnestly  supports  the 
opinion  that  moisture  is 
the  main  agent  in  the  pro- 
duction ot  diseases,  and 
considers  Holland  and 
Batavia  striking  instances 
to  prove  it. 

The  celebrated  Roman 
Physician  Folchi,  who  had 
bestowed  much  time  and 
attention  upon  this  sub- 
ject, thought  that  moist- 
ure, dampness,  and  the 
chilling  effects  of  the  dews 
of  night,  and  not  miasma- 
ta, produced  these  disea- 
ses. 

Lancisi  states  that  the 


way  concerned  m the  de- 
velopment of  carburetted 
hydrogen  gas.”  He  thinks 
“ the  most  dangerous  sites 
are  where  sea  water  finds 
access  to  marshes.” 

Tullock  thinks  moist- 
ure cannot  be  the  cause  of 
disease,  else  British  Guia- 
na, where  there  is  twice 
as  much  rain  as  in  Jamai- 
ca, would  be  more  sickly 
than  the  latter  place, 
whereas  it  is  twice  as  heal- 
thy. 

Murray,  British  Inspec- 
tor General  of  Hospitals, 
avers  that  fevers,  every 
way  analogous  to  those  to 
be  found  on  marshy 
plains,  frequently  result 
from  the  application  of  in- 
tense solar  or  atmospher- 
ic heat. 

Wortabet,  in  his  fevers 


ADDRESS  ON  MALARIA. 


117 


purest  breezes,  tametsi  sa- 
luberimus , no  matter  from 
what  quarter  they  may 
blow,  are  adequate  to  pro- 
duce an  attack  of  periodi- 
cal fever. 

Dr.  Heyne  accounts  for 
the  occurrence  of  these 
diseases  amongst  the 
rocky,  wooded  hills  of  the 
Madras  Presidency,  by 
supposing  them  to  be  ow- 
ing to  some  magnetic  in- 
fluence, dependent  upon 
the  ferruginous  character 
of  the  rocks. 

The  celebrated  Linnse- 
us  contended,  in  his  Inau- 
gural Essay,  that  periodi- 
cal fevers  originated  in  all 
those  places  where  the 
soil  abounds  in  clay,  and 
only  in  such  places ; whilst 
Fodere,  in  his  classificati- 
on of  insalubrious  locali- 
ties, places  the  clayey  soil 


of  Syria,  says  that  inat- 
tention to  personal  clean- 
liness, filth  and  poverty, 
independent  of  any  marsh 
effluvia,  will  produce  in- 
termittent fever. 

Yon  Aenvank,  a cele- 
brated Netherlander,  ac* 
counts  for  their  preva- 
lence in  argillaceous  soils, 
by  supposing  that  clay 
possessed  the  property  of 
absorbing  oxygen  from 
the  atmospheric  air,  and 
thus  impairing  its  purity. 

Dunglison,  contesting 
the  views  of  Fodere,  says: 
“It  certainly  cannot  be 
maintained  by  any  one 
who  has  inspected  the 
soils  of  malarious  regions, 
that  the  clayey  soil  is 
most  insalubrious  next  to 
the  marshy  and  turfy. — 
Some  of  the  most  healthy 


118 


ADDEESS  ON  MALAEIA. 


next  to  that  of  marshes 
and  turbaries. 


Fourcault  thinks  these 
fevers  depend  on  the  oc- 
currence of  three  essential 
conditions,  moisture  of 
the  air,  elevation  of  tem- 
perature, and  atmospher- 
ic vicissitudes. 


The  laity,  like  the  pro- 
fession, from  the  early 
teachings  of  the  miasma- 
tists,  as  well  as  from  the 
force  of  habit,  have  been 
accustomed  to  believe  that 
periodical  fevers  are  pro- 
duced by  an  emanation 
from  decaying  vegetable 
matter,  as  a formal  and 
specific  cause  which  is  es- 
sentially the  same,  and  in- 


districts are  found  of  this 
soil,  and  on  the  other 
hand,  as  we  have  previ- 
ously seen,  some  of  the 
most  unhealthy  are  san- 
dy.” 

Dr.  Foster  is  of  opinion 
that  it  is  not  the  heat,  nor 
cold,  nor  dampness,  nor 
drought  of  the  air,  nor 
sudden  changes,  which  is 
chiefly  concerned  in  pro- 
ducing disorders,  but  the 
inexplicable  peculiarity 
of  its  electrical  state. 

Dr.  Merrill  says,  in  his 
lecture  before  the  Mem- 
phis Medical  Society  : 
“ The  subject  of  the  cau- 
sation of  fever,  independ* 
ent  of  decaying  influence, 
has  of  late  years  gained 
such  importance,  how- 
ever, that  few  treatises 
are  now  written  upon  this 
disease,  without  advert- 
ing to  it,  although  most 


ADDRESS  ON  MALARIA. 


119 


of  what  we  find  in  our 
new  books,  upon  the  sub- 
ject of  fevers,  is  taken 
from  the  old  ones.” 

“ The  doctrine  of  a spe- 
cific poison,”  says  the 
American  Journal  of  the 
Medical  Sciences,  “ gene- 
rated  during1  the  slow  de- 

o 

composition  of  vegetable 
matter,  as  a cause  of  fe- 
ver, is  fast  losing  ground 
— as  the  etiology  of  en- 
demic and  epidemic  dis- 
eases is  more  closely  and 
systematically  investiga- 
ted.” 

I shall  now  mention  some  of  the  opinions  of  dif- 
ferent authors  as  to  the  causes  and  conditions  which 
are  said  to  affect  and  control  this  supposed  poison, 
marsh  miasm,  and  I think  we  shall  find  here  as  ma- 
ny discrepancies  as  were  exhibited  on  the  subject  of 
the  origin  of  periodical  fevers. 

CHARACTERISTICS  OF  MARSH  MIASM. 

Sir  Gilbert  Blane  states  Ferguson  says  that  the 
that  the  people  in  the  vil-  troops  were  sickly  “when- 
lages  in  the  midst  of  the  ever,  during  the  hot  sea- 


variable  in  all  countries 
and  situations. 


“ We  believe,”  says  the 
British  and  Foreign  Me- 
dico-Chirurgical  Review, 
“ that  we  are  as  yet  in  ut- 
ter ignorance  of  the  agent 
or  agencies  represented 
by  the  conventional  term 
malaria , or  marsh  poi- 
son.” 


120 


ADDRESS  ON  MALARIA. 


fens , were  in  general 
healthy  at  a time  when 
the  fever  was  prevailing 
in  the  more  elevated  sit- 
uations of  Lincolnshire. 


Monfalcon  states  that 
miasmata  during  the 
warmer  and  more  heated 
hours  are  elevated  to 
great  heights  in  the  at- 
mosphere, and  may  thus 
be  carried  to,  and  deposi- 
ted on,  distant  hills  and 
mountain  ridges. 

According  to  the  opin- 
ions of  Tournon,  Carriere 
and  others,  an  elevation 
of  from  five  to  seven  hun- 
dred feet  will  place  one 
beyond  the  influence  of 
miasmata,  no  matter  what 
may  be  the  nature  of  the 
localities  at  the  base  of 
such  situations. 


son  any  portion  of  the 
army  was  obliged  to  oc- 
cupy the  arid  encamp- 
ments of  the  level  coun- 
try, which  at  all  other 
times  were  healthy,  or  at 
least  unproductive  of  en- 
demic fever.” 

Ferguson  alleges  that 
it  is  heavier  than  air,  has 
a peculiar  attraction  for 
the  soil,  and  therefore 
cannot  mount  upwards, 
but  creeps  along  the 
ground,  whenever  i t 
strays  away  from  the 
source  of  its  origin. 

Major  Tulloch  does  not 
believe  that  an  elevation 
of  six  or  seven  hundred 
feet  will  ensure  one  against 
the  assaults  of  the  cause 
of  periodical  fever,  what- 
ever it  is,  but  goes  far  be- 
yond that,  and  thinks  an 
elevation  of  not  less  than 
2,000  or  3,000  feet  will  do 
it. 


ADDRESS  01ST  MALARIA. 


121 


On  tlie  coast  of  Batavia, 
according  to  Sir  John 
Lind,  so  little  attraction 
had  water  for  it,  the  ma- 
laria was  wafted  out  to 
vessels  riding  at  anchor 
some  five  or  sis  miles 
from  the  shore. 

Sir  J ohn  Pringle  affirms 
that  the  ground-floors  of 
the  houses  where  the  ma- 
laria is  disengaged  are 
most  sickly,  and  Ferguson 
and  others  agree  with  him 
that  it  is  less  deadly  as  it 
is  more  distant  from  the 
source  of  its  origin. 


Parent  Duchatelet,  a 
celebrated  physician  of 
Lyons,  after  several  years 
investigation,  came  to  the 
conclusion  that  water,  in 
which  hemp  or  flax  had 
been  rotted,  was  not  in- 


In  the  narrow  straits  of 
Holland,  only  a few  yards 
from  shore,  Sir  Gilbert 
Blane  says  none  of  the 
seamen  were  affected  by 
the  disease  which  was  so 
fatal  to  the  land  forces,  so 
great  is  the  attraction  of 
water  for  malaria. 

Monfalcon  declares  that- 
as  the  malaria  is  carried 
upwards  it  becomes  more 
energetic,  and  McCulloch 
agrees  with  him,  and  says 
that  the  source  of  its  ori- 
gin is  frequently  left  per- 
fectly salubrious,  whilst 
distant  hills  and  situations 
are  rendered  pestilential 
by  it. 

Brachet,  another  dis- 
tinguished physician  of 
Lyons,  gives  it  as  his  de- 
cided opinion  that  the 
readiest  and  most  certain 
method  of  converting  a 
healthy  village  into  a hot 


122 


ADDRESS  OK  MALARIA. 


jurious  to  the  health  of 
those  who  drank  it,  and 
that  the  emanations  from 
it  were  not  unhealthy. 

According  to  the  pre- 
vailing opinion,  it  is  only 
to  be  found  where  there 
are  marshes,  stagnant 
pools,  swamps,  or  wet 
rich  grounds. 


Dr.  Jas.  Johnson  says 
that  the  same  malaria 
arises  from  the  summits  of 
the  mountains  in  Ceylon, 
which  is  found  on  the 
marshy  plains  of  Bengal. 

Dr.  Dickson,  of  Charles- 
ton, S.  C.,  a popular  writ- 
er of  this  country,  says: 
“ A very  dry  summer  and 
spring  are  apt  to  be 
healthy,”  and  Folchi  and 
others  agree  with  him. 


bed  of  intermittent  fevers, 
is  to  furnish  it  with  ponds 
and  steep  hemp  in  them. 

Dr.  Macmichael  says, 
Trichori,  in  the  Gulf  of 
Yolo,  in  Greece,  a dry 
limestone  rock,  is  noto- 
rious for  its  malaria,  which 
is  likewise  true  of  one  of 
the  Isles  de  Loss,  accord- 
ing to  Boyle. 

McCulloch  asserts  that 
in  every  instance  where 
it  is  found  on  the  hills  and 
"mountain  ridges,  it  always 
arises  from  the  wet  oround 

O 

at  their  base,  or  at  no  very 
great  distance  off. 

Ferguson  says : “ a year 
of  stunted  vegetation, 
through  dry  seasons  and 
uncommon  drought,  is  in- 
fallibly a year  of  pesti- 
lence to  the  greater  part 
of  the  West  India  Islands. 


ADDRESS  ON  MALARIA. 


123 


Robert  Jackson  says: 
“The  usual  endemic  of 
warm  climates  is  less  fre- 
quent and  formidable  on 
the  banks  of  rivers,  after 
their  waters  become  mix- 
ed with  the  sea,  than  be- 
fore this  has  happened.” 

Folchi  thinks  a hot, 
dry  summer  most  exempt 
from  fevers ; and  the  most 
sickly  one  is  when  falls  of 
rain  alternate  with  at- 
mospherical vicissitudes 
of  temperature. 


M.  Julia  ascribes  it  to 
a union  of  animal  and 
vegetable  putrefaction ; 
and  Dr.  James  Johnson 
thinks,  generally  speak- 
ing, it  is  the  product  of 
animal  and  vegetable  de- 
composition, by  means  of 
heat  and  moisture. 


Fodere,  speaking  of  this 
matter,  says  the  shores 
and  vicinity  of  large  ri- 
vers, lakes  and  the  sea 
are  generally  healthy,  urn 
less  where  there  is  an  ad- 
mixture of  salt  with  fresh 
water. 

Dr.  Joseph  Brown  as- 
serts he  has  seen  plenty 
of  ague  and  fever  in  parts 
of  Estremadura,  when 
everything  was  parched 
up  for  want  of  rain,  and 
where  no  visible  damp- 
ness could  be  supposed  to 
have  a share  in  their  pro- 
duction. 

Dr.  Jos.  Brown  says : 
“Malaria  is  generated  in 
so  many  instances  in  which 
animal  matter  does  not 
exist,  that  we  must  con- 
clude that  the  presence  of 
such  matter  is  not  essen- 
tial to  the  formation  of 
the  poison.”  Dunglison 
and  others  agree  with  him 
in  this  opinion. 


124 


ADDRESS  ON  MALARIA. 


Copland,  in  his  Diction- 
ary of  Practical  Medicine  ? 
says  : “In  warm  countries 
or  in  hot  seasons  in  tem- 
perate climates,  the  pla- 
ces which  are  most  pro- 
ductive of  malaria  gener- 
ally, also  abound  the  most 
in  animal  substances  un- 
der going  decomposition 
again,  “ I have  always  con- 
sidered the  number  of  in- 
sects and  reptiles  with 
which  a place  abounds  as 
more  indication  of  its  in- 
salubrity than  almost  any 
other  circumstance.’1 


Dr.  Gardner  attempts 
to  account  for  the  absence 
of  malaria  from  certain 
marshes,  viz : those  around 
Boston,  and  the  bogs  of 
Ireland,  and  the  marshes 
of  Scotland — by  suppos- 


Armstrong  says,  Kings- 
ston,  in  the  Island  of  St. 
Vincent,  having  all  the 
elements  for  the  produc- 
tion of  this  poison,  for  it 
abounds  in  as  much  vege- 
table matter,  and  “ rep- 
tiles, and  insects,  and 
other  animal  matter  as  is 
found  in  other  tropical 
countries,  is  yet  as  heal- 
thy as  the  most  favorable 
spot  in  England.”  New 
Amsterdam,  Berbice,  and 
other  places  in  the  West 
Indies,  are  similarly  situ- 
ated, according  to  Fergu- 
son; while  Dundas  informs 
us  that  such  is  the  case 
with  Bahia,  Bomfim  and 
other  places  in  Brazil. 

Most  other  writers  en- 
deavor to  account  for  the 
exemption  from  the  mala- 
ria enjoyed  by  the  bogs 
of  Ireland  and  the  marsh- 
es of  Scotland  and  some 
marshes  in  other  coun- 


ADDRESS  ON  MALARIA. 


125 


ing  that  iron,  or  zinc,  or 
some  other  metals  exist  in 
the  sub-soil,  and  that  these 
by  uniting  with  the  sul- 
phur, prevent  the  devel- 
opment of  sulphuretted 
hydrogen.  McCormac 
thinks  the  absence  of  suf- 
ficiently high  and  continu- 
ed heat  is  the  reason  Ire- 
land is  exempt  from  peri- 
odic fevers. 

Forsythe,  Ferguson,  Sir 
John  Pringle,  Sir  Charles 
Morgan  and  others,  con- 
tend that  a dry  road,  or  a 
wall,  or  a belt  of  trees  will 
arrest  the  progress  of  this 
poison.  And  Watson 
thinks  a moat  (perhaps) 
round  a house  will  stop  it. 

Sir  John  Pringle,  For- 
dyce  and  Ferguson,  de- 
clare that  the  dry  sandy 
plains  of  South  Holland, 
Dutch  Brabant  and  Flan- 
ders, without  trees,  were 
pestilential  to  the  British 
forces. 


tries  by  supposing  that 
the  vegetable  matter  in 
them  is  in  a subcarbonized 
state,  and  therefore  does 
not  give  off  miasmatic  ex- 
halations. This  is  the  sup- 
position of  Weld,  Craigie 
Watson  and  others  about 
the  Dismal  Swamp,  but 
it  is  a mistake. 


Monfalcon,  McCulloch, 
Brown  and  others  say  it 
will  mount  into  the  higher 
regions  of  the  air,  and 
be  disseminated  over  the 
adjacent  country,  despite 
the  intervention  of  walls, 
cliffs,  woods  and  second- 
ary ridges. 

Heber  says  the  wood 
tracts  of  Nepaul  and  Mal- 
wa, having  neither  swamps 
nor  perceptible  moisture, 
are  uninhabitable  in  sum- 
mer and  autumn  by  man, 
beasts,  or  birds,  from  them 
pestilential  character. 


126 


ADDRESS  OK  MALARIA. 


The  miasmatists,  gene- 
rally, believe  that  the 
dews  of  insalubrious  lo- 
calities are  loaded  with 
the  miasmatic  principle, 
which  has  been  brought 
down  and  precipitated 
with  the  aqueous  vapor 
of  the  atmosphere. 

Sir  John  Pringle  and 
others  assert  that  this 
poison  is  connected  with 
a most  noisome  and  dread- 
ful smell. 


The  prevailing  opinion 
among  the  miasmatists  is 
that  it  is  not  contagious, 
though  some  believe  it  is 
capable  of  hereditary 
transmission. 

Fordyce,  Sir  John  Lind, 
Dr.  Dundas,  the  French 


Dr.  Minzi,  of  the  Cen- 
tral Hospital,  Terracina, 
with  the  view  of  testing 
this  matter,  together  with 
others,  drank  freely  of  the 
dews  of  such  localities 
besides  washing  abraded 
surfaces  and  the  sores  of 
peasants  with  it,  without 
evil  effects. 

Ferguson  says  a most 
noisome  and  disgusting 
odor,  arising  from  the  de- 
composition of  vegetable 
matter,  pi  rvades  the  town 
of  Hew  Amsterdam,  Ber- 
bice,  but  it  does  not  pro- 
duce disease. 

Bailly  and  Audouard, 
in  France,  and  Cleghorn, 
Fordyce  and  Brown,  in 
Great  Britain,  think  that 
it  is  communicable  by 
contagion. 

o 

Those  who  advocate 
the  abstract  theory  that 


ADDRESS  021  MALARIA. 


127 


Algerian  Surgeons,  and  marsli  miasm  is  the  cause 
others,  contend  that  fever  of  periodical  fevers,  deny 
and  ague  is  convertible  that  ague  and  fever,  and 
into  common  continued  continued  fever,  are  mu- 
fever,  and  vice  versa.  tually  convertible. 

These  are  some  of  the  varying  features  and  con- 
tradictory statements,  which  are  furnished  by  the 
medical  history  of  this  imp  of  the  marshes.  I shall 
not  attempt  to  reconcile  such  discordant  elements. 
But  if  you  should  think  I have  placed  too  much  im- 
portance upon  these  conflicting  opinions,  I have  only 
to  say,  that  I have  brought  them  forward  in  this  con- 
nection as  a proper  argument,  because  such  differen- 
ces cannot  be  explained  as  resulting  from  one  primary, 
-specific,  and  indivisible  cause,  without  bidding  defiance 
to  the  established  principles  of  correct  reasoning,  and 
the  plainest  dictates  of  common  sense. 

Before  concluding,  as  I understand  it  is  expect- 
ed of  me,  I will,  in  as  few  words  as  possible,  endeav- 
or to  give  you  an  idea  of  my  own  views  upon  this  sub- 
ject. I regret  that  the  daily  business  pursuits  of  a la- 
borious profession  have  not  allowed  me  the  time  and 
opportunity  thoroughly  to  investigate  and  elaborate 
my  opinions.  But,  whatever  of  observation,  and  re- 
flection, and  reading  I have  been  able  to  bestow  upon 
this  matter,  have  brought  me  to  the  conclusion  that 
endemic  fevers  are  natural  occurrences,  chiefly  inci- 
dent to  particular  localities,  and  must  be  accounted 


128 


ADDRESS  OX  MALARIA. 


for  on  tlie  principle  of  natural  causes.  And  that  at- 
mospheric disturbances,  such  as  the  variations  of  tem- 
perature, by  whatever  means  effected,  but  as  mani- 
fested more  particularly  by  the  varying  degrees  of 
heat  during  the  different  hours  of  the  day,  and  in  the 
night-time,  in  the  same  locality,  and  at  the  same  sea- 
son of  the  year ; hygrometrical  influences,  atmospher- 
ic pressure,  electrical  tension  and  states  of  the  air  and 
earth’s  surface,  as  affected  by  the  foregoing  enumera- 
ted conditions  of  the  atmosphere,  and  upward  radia- 
tion of  heat,  especially  at  night,  are  the  exciting 
causes  of  periodic  fevers,  of  which  intermittents  are, 
in  ny  opinion,  the  primordial  type.  On  the  other 
hand — want  of  light,  want  of  ventilation,  impure  air 
and  noxious  vapours,  from  whatever  source  arising ; 
scanty  diet,  impure  food,  inattention  to  personal  clean- 
liness, want  of  comfortable  quarters,  over-exertion, 
dissolute  habits,  an  irregular  and  artificial  mode  of 
life,  by  enervating  and  otherwise  spoiling  the  natur- 
al tone  and  healthy  vigor  of  the  system,  become  pre- 
disposing causes,  rendering  it  more  or  less  liable  to  be 
affected  by  the  exciting  cause. 

P.  S.  Since  the  above  was  written  and  delivered, 
I have  seen  and  carefully  read  the  recent  very  learn- 
ed and  elaborate  work  by  R.  La  Roche,  M.  D.,  of 
Philadelphia,  on  “ Pneumonia,  its  supposed  connec- 
tion, pathological  and  etiological,  with  autumnal  fev- 


ADDRESS  ON  MALARIA. 


129 


ers ; including  an  inquiry  into  the  existence  and  mor- 
bid agency  of  malaria but  it  has  failed  to  convince 
me,  as  I think  it  will  every  honest  and  unprejudiced 
inquirer  after  truth,  of  the  existence  of  a specific  gase- 
ous poison,  emanating  under  certain  circumstances  of 
heat  and  moisture,  from  the  decomposition  of  organ- 
ic substances.  On  the  contrary,  if  it  proves  any- 
thing, it  proves  too  much,  and  quod  probat  nimis , pro- 
bat nihil , is  a wise  maxim,  which,  when  applicable, 
should  be  fatal  to  any  effort,  whether  made  for  the 
purpose  of  laying  down  the  important  facts  and  elu- 
cidating the  great  principles  of  a correct  theory  of 
causation,  or  for  the  establishment  of  truth  before  a 
tribunal  of  justice. 

Dr.  La  Roche  believes  that  this  poison  is  of  a. 
vegeto-animal  nature,  not  an  evolution  from  vegetable 
decomposition  singly,  nor  from  animal  putrifaction 
alone,  although  he  does  not,  by  any  means,  assert 
that  emanations  from  either  of  these  souroes  will 
not  produce  autumnal  fevers ; nor,  in  fact,  that  they 
may  not  be  of  cyptogamous,  or  animalcular  origin  ;• 
whilst  he  distinctly  admits  that  not  only  yellow  fever, 
but  typoid  fever,  and  even  oriental  plague  are  mala- 
rial diseases,  although  he  scouts  the  idea  of  their 
pathological  identity. 

Indeed,  the  author  does  not  call  upon  us  to  ren- 
der our  assent  to  the  demonstrable  existence  of  a dis- 
tinct appreciable  gaseous  entity , possessing  specific- 

poisonous  properties,  and  proceed  to  prove  this  pro- 
9 


130 


address  on  malaria. 


position,  but  we  are  required  to  admit  the  existence 
of  an  aeriform  poison  of  mixed  “ composition  and  na- 
ture ” — a variety  of  miasm-s — which,  although  inap- 
preciable in  themselves,  he  says,  following  Laneisi 
and  others,  are  capable  of  producing  a “great  diver- 
sity of  effects”  according  to  their  difference  “materi- 
ally in  composition  and  nature.”  Thus,  at  one  time, 
believing  “ that  miasmata  or  exhalations  produce  dif- 
ferent forms  of  fever,”  and  that  “ he  is  justified  in  the 
belief,  considering  the  great  diversity  of  effects  pro- 
duced,” he  does  not  wish  “ to  be  understood  as  main- 
taining that  those  exhalations  are  always  identically 
the  same  in  their  nature for  “ the  malignant  forms  of 
such  diseases  (periodical  fevers)  are  never  produced 
by  the  effluvia  of  genuine  marshes,  but  are  the  pro- 
ducts of  other  miasmal  sources  ; while,  on  the  contra- 
ry, fevers  known  to  arise  from  marsh  exhalations,  are 
never  produced  by  the  effluvia  which  occasion  the 
other  forms  of  the  disease .”  At  another  time,  allud- 
ing to  this  miasm,  familiarly  spoken  of  everywhere 
in  this  work  as  a poison,  and  supposed  by  the  author 
to  be  of  a vegeto-animal  origin  and  nature,  he  declares, 
“ that  it  possesses  an  individuality  of  its  own,  and  ser- 
ves by  its  poisonous  properties  to  render  the  air 
of  localities  where  it  is  generated  or  conveyed,  insalu- 
brious, and  a fruitful  source  of  fever.” 

Now,  if  we  urge  these  premises  to  their  legiti- 
mate conclusions,  we  shall  necessarily  have,  for  the 


ADDRESS  ON  MALARIA. 


131 


milder  intermittents  and  remittents,  and  for  the  more 
malignant  forms  of  those  diseases,  and  for  yellow  fe- 
ver certainly,  and  typhoid  and  typhus  fevers,  and  even 
oriental  plague,  perhaps,  a separate,  formal,  and  spe- 
cifically poisonous  aeriform  cause,  each  of  which,  al- 
though it  is,  in  his  opinion,  of  vegeto-animal  nature 
and  composition,  “ possesses  an  individuality  of  its  own, 
and  serves  by  its  poisonous  properties  to  render  the 
air  of  localities  where  it  is  generated  or  conveyed,  insa- 
lubrious, and  a fruitful  source  of  fever.”  And  thus  we 
may  have,  according  to  Dr.  La  Roche,  aeriform  causes 
of  disease,  each  differing  from  the  other  and  speci- 
fically poisonous,  but  all  of  a vegeto-animal  essence, 
existing  together  in  the  same  atmosphere,  as  we  some- 
times have  the  mildest  and  the  most  malignant  forms 
of  intermittent  and  remittent  feVers,  and  even  yel- 
low and  continued  fevers,  prevailing  in  the  same  lo- 
cality at  the  same  time.  Yet,  notwithstanding  all 
this,  it  is  certainly  true  that  he  has  not  been  able  to 
establish  by  just  and  proper  inference  even,  much  less 
by  demonstration,  either  the  existence  or  the  nature 
and  essence  of  any  one  of  these  causes  ; or  to  lay 
down  the  circumstances  which  certainly  produce  them, 
or  the  primary  laws  which  they  obey,  or  the  mode 
in  which  they  produce  those  symptoms  we  have 
empirically  determined  fever. 

Again,  when  denying  the  etiological  value  of  the 
abnormal  states  of  the  atmosphere,  in  producing  au- 


132 


ADDRESS  ON  MALARIA. 


tumnal  and  yellow  fever,  he  says:  “We  may  safely 
affirm  that  excessive,  great  or  long  eontinned  heat 
will  not  do  so — and  that  “ this  want  of  necessary 
connection,  as  cause  and  effect,  between  high  atmos- 
pherical heat  and  fever — common  autumnal  and  yel- 
low— has  been  pointed  out  by  a large  number  of  wri- 
ters on  these  diseases,  as  they  show  themselves  in  va- 
rious parts  of  the  globe while  in  another  place, 
speaking  of  malarial  fever,  he  remarks  : “ It  is  em- 
phatically a disease  of  hot  weather,  requiring  for  its 
production  a continuance,  for  some  time  previous,  of 
high  atmospheric  heat.  It  appears,  generally,  some 
weeks  after  the  hottest  month,  the  period  being  re- 
tarded as  we  proceed  North.  For  the  same  reason  it 
may  readily  be  understood  to  be  a disease  of  hot  la- 
titudes, prevailing  as  it  does  violently  and  almost  per- 
petually within  the  tropics,  and  ceasing  long  before 
we  reach  the  polar  circle.” 

And  so,  speaking  of  fever  on  the  African  coast,  he 
says : “ It  is  at  this  period  (the  hottest  of  the  year,) 
that  remittent  fevers  usually  make  their  appearance. 
In  the  west  Indies,  the  period  of  the  greatest  liabi- 
lity is  between  July  and  December,  when  the  hot- 
test weather  combined  with  considerable  moisture, 
prevails.”  And  in  treating  of  the  fevers  of  Ceylon 
and  Bengal,  he  declares  that : “In  a word,  the  epoch 
of  appearance  may  vary  in  different  localities,  accord- 
ing to  the  situation  of  those,  and  their  position  rela- 
tive to  the  equator,  and  the  consequent  modification 


ADDRESS  ON  MALARIA. 


133 


of  tlie  period  of  the  seasons ; but  everywhere  endem- 
ic or  autumnal  fevers  break  out  or  are  most  rife  dur- 
ing or  shortly  after  the  hottest  weather.”  But  not- 
withstanding all  these  admissions  on  the  part  of  Dr. 
La  Roche,  as  to  the  agency  of  heat,  or  heat  combin- 
ed with  moisture,  as  the  necessary  cause  of  fevers, 
“ common  autumnal  and  yellow,”  he  nevertheless 
thinks  we  may  safely  affirm  that  excessive,  great  or 
long  continued  heat  will  not  account  for  them,  and 
that  heat  and  humidity  combined  are  “ not  the  effici- 
ent cause  of  fever.” 

With  regard  to  the  influence  of  winds  in  the  pro- 
duction of  fevers  he  is  equally  imprecise  and  unsatis- 
factory. In  one  place  he  quotes  Dr.  Bone  to  prove 
that  yellow  fever  “ prevails  in  Brimstone  Hill,  St. 
Kitts,  when  the  strong  winds  that  have  swept  foul 
ground  on  mount  Misere,  impinge  upon  the  persons 
in  the  ill-constructed  barracks  and  out  buildings  on 
that  hill ;”  whilst  in  another  place,  he  asserts  the  di- 
rect morbific  action  of  winds  without  the  circum- 
stance of  their  passing  over  “ foul  ground”  when  he 
says : ’’and  in  Tobago,  Dominica,  Grenada,  St.  Vincent, 
and  on  all  the  hilly,  uncleared  islands  of  the  West  In- 
dies, strong  north  and  east  winds,  impinging  upon 
the  troops  and  their  families,  in  ill-constructed  bar- 
racks, are  causes  of  disease.” 

Again,  he  quotes  with  decided  approbation,  the 
strong  and  unequivocal  testimony  of  Lefort,  to  prove 
the  morbific  influence  of  certain  winds,  in  producing 


134 


ADDRESS  OX  MALARIA. 


yellow  fever  wliere  there  is  no  agency  of  foul  exhala- 
tions expressed  or  implied  even  in  their  causative  ac- 
tion. 

Thus  Lefort  says : “ The  development  of  the  yel- 
low fever,  in  the  West  Indies,  in  a great  number  of 
men  at  the  same  time,  in  different  parts,  at  a distance 
from  each  other,  on  a level  with  the  sea  or  slightly 
above,  on  board  vessels  at  port  or  at  sea,  coincides  so 
exactly  with  the  prevalence  of  the  south  winds,  that 
it  is  impossible  not  to  recognize  in  these  meteorologi- 
cal conditions  the  true  cause  of  the  epedemic  of  yel- 
low fever.  The  effect  here  is  intimately  and  neces- 
sarily connected  with  its  cause.  The  production 
and  extension  of  yellow  fever  under  the  prolong- 
ed influence  of  the  south  winds,  is  a fact  observed 
by  every  one ; so  inevitable,  indeed,  that  it  can 
be  predicted  without  fear  of  being  ever  mistaken. 
This  action  of  the  south  winds  is  felt  here  by  every 
thing  that  breathes.  They  produce  undefinable 
effects  on  our  senses.  We  feel  them  in  bed,  or 
sitting  at  the  desk  ; they  euervate,  cause  oppres- 
sion, and  distress  the  spirits.  To  say  in  what  these 
atmospherical  alterations,  the  effects  of  which  are 
so  much  to  be  dreaded,  consist,  and  to  seek  to  deter 
mine  their  specific  nature,  is,  doubtless,  a task  beyond 
the  faculty  of  man.” 

Notwithstanding,  therefore,  the  very  extensive 
survey  of  facts  and  authorities,  which  have  been 


ADDRESS  OX  31 AL ARIA. 


135 


brought  forward  in  this  connection  by  Dr.  La  Roche, 
and  which  unquestionably  will  prove  quite  a lift  for 
the  lazy,  it  would  not  be,  I conceive,  a very  difficult 
task  to  point  out  many  illogical  conclusions  and  incon- 
sistencies in  this  work,  which  have  resulted,  no  doubt, 
from  hasty  generalization,  in  attempting  to  square 
facts  with  preconc  ived  opinions,  or  from  a total  for- 
getfulness in  one  place  of  what  had  been  said  in  ano- 
ther ; but  this  is  neither  the  time  nor  place  to  enter 
upon  such  a work. 

To  the  term  malaria  there  can  be  no  particular 
objection,  when  used  merely  to  convey  an  impression 
of  the  morbific  state  of  the  atmosphere  of  certain  lo- 
calities. But  it  is  a different  thing  when  employed 
by  the  school-men  as  a familiar  expression,  represent- 
ing a distinct  gaseous  entity,  possessing  essential  pro- 
perties, specifically  poisonous  in  their  nature,  since  = 
neither  the  existence  of  the  gas,  nor  its  composition, , 
nor  qualities,  can  be  appreciated  by  our  senses  in 
their  natural  state,  nor  aided  by  all  the  contrivances, 
which  science  and  ingenuity  can  suggest,  nor  traced 
even  by  the  presence  of  those  agencies  which  are  said 
to  be  capable  of  generating  it ; for  Dr.  La  Roche  ad- 
mits, “ that  fevers  prevail  sometimes  even  in  arid 
places  with  want  of  surface  water,,  where  the  soil  is 
rocky,  or  sandy,  parched,  and  deficient  in  vegetation 
and  where,  in  a word,  circumstances  generally  are,  in 
appearance  at  least,  unfavorable  to  the  decay  of  or- 
ganic matter.”  And  then,  again,  that : u It  not  un- 


136 


ADDRESS  ON  MALARIA. 


frequently  happens  that  in  localities  where,  from  the 
character  of  the  soil,  or  the  nature  and  condition  of 
the  substance  by  which  the  surface  is  covered,  as  well 
as  from  the  heat  and  moisture  of  the  climate,  febrile 
complaints  might  be  expected  to  occur,  they  are,  ne- 
vertheless, seldom  or  never  encountered.” 

Furthermore,  whilst  contending  that  “occurren- 
ces on  shipboard  prove  the  agency  of  malaria,”  he 
not  only  admits  the  difficulties  which  surround  his  po- 
sition, but,  as  I think,  almost,  if  not  quite  surrenders 
the  main  question ; for  he  declares  that  “ all  vessels 
containing  vegetable  and  other  matters  in  a state  of 
incipient  or  decided  decomposition,  lying  in  southern 
ports  or  navigating  southern  waters,  even  in  warm 
weather,  are  not  all  expected  to  suffer  from  fever,” 
because  the  “sources  of  vegetable  and  other  decom- 
position on  board  of  ships,  are  under  the  control  of 
some  of  the  same  agencies,  which,  as  we  have  seen, 
modify  the  effects  of  like  sources  of  contamination  on 
land.  They  require,  before  they  can  generate  fever, 
to  be  acted  upon  by  high  atmospherical  heat  ; that 
this  heat  should  continue  a certain  length  of  time; 
that  the  season  should  be  that  in  which  the  fever  usu- 
ally prevails  ; and  that  there  should  exist  a suitable 
epidemic  constitution  of  the  atmosphere.  Remove 
all  these  contingencies,  and  foul  ships  will  generally 
be  found  to  remain  healthy.”  In  the  same  manner, 
and  with  equal  earnestness,  he  had  before  insisted 
“ that  some  marshy  surfaces”  and  “ sources  of  vege- 


ADDRESS  OH  MALARIA. 


137 


table  and  other  decomposition”  on  land  “ prove  com- 
pletely, or  to  a great  extent,  innocuous  in  certain  sea- 
sons, and  even  during  a succession  of  years,”  be- 
cause the  effluvia  from  them  are  harmless  unless  aided 
by  high  and  long  continued  heat ; a certain  hygrome- 
toical  condition;  the  season  of  the  year  when  these 
diseases  usually  prevail ; and  a suitable  epidemic  con- 
stitution of  the  atmosphere.  What  a theory  of  cau- 
sation ! In  the  first  place,  he  assumes  the  existence 
of  a cause,  an  indispensable  something,  with  nei- 
ther appreciable  qualities,  nor  capable  of  demonstra- 
ble being ; yet,  without  which,  as  he  assures  us,  perio- 
dical fever  could  not  exist.  And  then,  in  the  second 
place,  finding  himself  unable  by  this  means  to  solve 
the  certain  difficulties,  which  arise  on  either  hand  de- 
manding an  explanation,  he  claims  the  presence  and 
aid  of  a series  of  contingencies,  most  of  them  palpa- 
ble facts  or  appreciable  agents.  Thus,  in  violation  of 
all  the  just  rules  of  philosophizing,  he  superadds  a 
hypothetical  to  known  causes,  which  known  causes 
other  etiologist  in  a more  philosophic  spirit  believe  of 
themselves  capable  of  producing  these  diseases  ; while 
the  absence  of  any  one  of  them,  especially  the  last, 
itself  an  unknown  condition  of  things,  may  render  Dr. 
La  Roche’s  whole  theory  a baseless  fabric,  and  this 
primum  mobile  et  causa  sine  qua  non  totally  inopera- 
tive, and  therefore  a nonentity,  since  it  is  only  by  its 
supposed  effects  that  he  even  assumes  to  know  cer- 
tainly of  its  existence. 


138 


ADDRESS  ON  MALARIA. 


In  this  view  of  the  subject,  it  seems  to  me  to  be- 
come one  of  those  instances  of  faulty  reasoning  so 
graphically  described  by  Locke,  in  liis  great  work  on 
the  human  understanding,  when  speaking  of  the  use 
of  terms,  purely  conventional,  arbitrary,  and  without 
definite  meaning,  by  the  Peripatetics,  Platonists  and 
Epicureans.  “ There  is,”  he  remarks,  “ scarce  any 
sect  in  philosophy  that  has  not  a distinct  set  of  terms, 
that  others  understand  not ; but  yet  this  gibberish, 
which,  in  the  weakness  of  human  understanding, 
serves  so  well  to  palliate  men’s  ignorance  and  cover 
their  errors,  comes,  by  familiar  use  among  those  of 
the  same  tribe,  to  seem  the  most  important  part  of 
language,  and  of  all  others  the  most  significant. — 
And  should  aerial  and  etherial  vehicles  come  once, 
the  prevalence  of  that  doctrine,  to  be  generally  re- 
ceived anywhere,  no  doubt  those  terms’  would' make 
impressions  on  men’s  minds,  so  as  to  establish  them  in 
the  persuasion  of  the  reality  of  such  things,  as  much 
as  peripatetic  forms  and  intentional  species  have  here- 
tofore done.” 

However,  I must  acknowledge,  from  the  great 
learning  which  Dr.  La  Roche  has  displayed,  in  the 
careful  and  painstaking  collocation  of  facts  and  au- 
thorities, under  the  different  heads  of  inquiries  and 
subdivisions  of  the  main  subject,  systematically  insti- 
tuted by  him,  that  he  has  indissolubly  connected  his 
name  with  the  medical  literature  of  malaria,  besides 


ADDRESS  ON  MALARIA. 


139 


furnishing  those  who  have  not  the  time  or  inclination 
to  study  out  this  question  for  themselves,  an  easy  and 
agreeable  acquaintance  with  those  eminent  medical 
men  who  have  written  upon  this  subject. 


THE  END.. 


616.456 


J66A  56544 


